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* 1. Parent/Guardian Name

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* 2. Student Name 

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* 3. Does your child have access to the internet daily?

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* 4. Does your child have access to a device that they can connect to the internet and engage in schoolwork for 2-4 hours daily?

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* 5. For student assignments and schoolwork, I am able to 

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* 6. We realize that young children will need support from a member of their home to complete the assignments necessary to continue their education outside of of school. Caregivers might be required to read lessons to children, watch videos with their children and engage in discussions. How many hours/ day is their an adult in your home who can provide this support?

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* 7. Please share any questions, comments, concerns or supports you may need or can offer other families. 

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