Digital Equity Survey

Digital Equity Survey
Student ID
Student First Name*
Student Last Name*
Student Attends
Student Attends - Please select one school*
Does this student have access to the internet at their primary place of residence? (SELECT ONE)*

YesNo
If No, what barrier prevents the student from having internet access at their primary place or residence?
Describe Other circumstances that prevent the student form having Internet access
What is the primary type of internet services used in the student’s primary place ofresidence? (SELECT ONE)*

Residential BroadbandCellular NetworkHot SpotCommunity Provided Wd‐FiSatelliteDial‐upOtherNoneUnknown
Can the student complete a full range of learning activities without interruptions caused by poor internet performance in their primary place of residence? (SELECT ONE)*

Yes – Few or no internet interruptionsSometimes – Regularly experience internetNo – Unable to access internet
Select the provider of the primary learning device: (SELECT ONE)*

District ProvidedPersonalOther
Is the primary learning device shared or not shared with another individual? (SELECT ONE)*

SharedNot SharedUnknown
What type of device does the student use most often to complete learning activities away from school?(SELECT ONE)*

Desktop ComputerLaptop ComputerTabletChromebookSmartphoneNoneOther
If you selected "Other" for your type of device, please explain
Should be Empty: