1. What technology devices do your children have access to utilize at home?
(Please check all that apply)
[ 1] Desktop
[ 2] Laptop, Netbook, or Chromebook (any brand)
[ 1] Tablet (e.g. iPad, Android, Nook, Fire, etc.)
[ 6] Smartphone or “Phablet”
[1 ] Do not have a technology device at home.
2. Does your home have Internet Access?
[ ] Yes. Cable modem.
[1 ] Yes. Fiberoptic (e.g. FiOS, Google)
[ } Yes. DSL
[ ] Yes. Dial up.
[ ] Yes. Tethering to a Smartphone or Tablet.
[ 1] Yes. Laptop with imbedded wireless modem.
[ 7] Free data
[ ] No. We do not have internet access at home.
3. If you do not have Internet access at home, do you have an alternate method for accessing the
internet?
[ 2] No. We cannot access the internet.
[ 1] Yes. Access at internet cafe or business establishment
[ 3] Yes. Borrow an internet enabled device from a family member or friend.
[ 1] Yes. Access at a friend or family member’s home.
[ 3] Yes. Willing to invest for the internet connections