Fifth Grade Educational Support Survey

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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?

Yes

No

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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?

Yes

No

Comments

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

Print from home

Pick up assignments and schoolwork from the office at prescribed times

I am unable to print or pick up assignments

Support needed (please be specific)

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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?

0-1 hours

2-4 hours

4+ hours

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