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Home Technology Access Survey

You only need to complete one form PER household.

Parent/Guardian First Name

Answer Required

Parent/Guardian Last Name

Answer Required

Does your household have access to a device such as a phone, tablet or computer that is able to play videos?*

Answer Required

Yes

Do you have internet capabilites to stream or download videos on your device?*

Answer Required

Yes

No, I am not able to download or stream videos onto my device

No, my household does not have access to a device as mentioned above

Confirmation Email

Confirmation Email *

Email Required