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Home
Students
Educators
Administrators
Advancing CA Adult Education
Events
Launchboard
Request Support
Home
Students
Educators
Administrators
Advancing CA Adult Education
Events
Student Technology Intake Survey
If you have already filled out this survey
this school year
, you do not have to fill it out again.
A printable PDF version of this survey is available for download here:
Student Technology Intake Survey
To see this form in your language use the
"Select Language"
button in the top-right of the page and make your choice.
* indicates required fields
1. Where do you go to school?
*
Select the drop-down list and type the first letter of your school name to jump to that section of the list.
Watsonville/Aptos/Santa Cruz Adult Education (Pajaro Valley Unified School District)
2. What is your first and last name?
First
Last
3. Choose the classes or programs that interest you. (Check all that apply)
*
Basic Skills
High School Diploma
High School Equivalency (GED, HiSET)
English as a Second Language
Citizenship Preparation
Career Technical Education
4. Do you use email?
*
Yes
No
5. How do you communicate or talk with others? (Check all that apply)
Text (SMS/iMessage)
Email
WhatsApp
Other
6. Have you ever taken an online (remote) class?
*
Yes
No
7. Do you prefer to learn online (remote), in-person, or both (hybrid)? Please explain why.
*
Online (remote)
In-person
Both (hybrid)
Why do you like to learn this way?
8. What devices do you use? (Check all that apply)
*
Cell phone
Do you
own
a cell phone?
Do you
share
a cell phone?
Do you
use
a cell phone
for online learning
?
Tablet
Do you
own
a tablet?
Do you
share
a tablet?
Do you
use
a tablet
for online learning
?
Laptop or Computer or Chromebook
Do you
own
a laptop or computer or Chromebook ?
Do you
share
a laptop or computer or Chromebook?
Do you
use
a laptop or computer or Chromebook
for online learning
?
9. How do you connect to the internet? (Check all that apply)
*
Through my phone
Wifi/Internet connection in my home
Personal Hotspot
WiFi in the community
WiFi at school
Other
10. Do you have reliable and affordable internet at home?
*
Yes
No, it is too expensive right now
No, it usually doesn’t work
No, it is too slow to use
11. Please mark the items below that would help you to study online. (Check all that apply)
*
A device to help me study online
Help to get on the Internet like a mobile hotspot
Tech support getting into online classes, using online resources, fixing equipment, etc.
Flexible study times
A basic computer or keyboarding class
I do not need additional help
Other
12. Do you know how to keep your information safe when using a computer or going online?
*
Yes
No