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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?
*
Delano Adult School (Delano Joint Union High School District)
2. What is your first and last name?
First
*
Last
*
3. What classes do you want to take? (Check all that apply)
*
Basic Skills
High School Diploma
High School Equivalency (GED, HiSET, TASC)
English as a Second Language
Citizenship Preparation
Career Technical Education
4. What are your career, employment, or educational interests or goals?
5. Do you use email?
*
Yes
No
6. If you answered yes to Question 5, what is your email address?
7. What is a cell phone number where you can be reached?
8. Have you ever taken an online (remote) class?
*
Yes
No
9. 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?
10. What do you use for online learning? (Check all that apply)
*
Cell phone
Tablet
Laptop or Computer or Chromebook
Not sure
I don't have a device
11. Do you share this computer, laptop, tablet, or phone with others?
*
Yes
No
12. 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
13. 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
14. Do you have a quiet place to study at home?
*
Yes
No
15. 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
16. How did you hear about our school? (Check all that apply)
Website
Catalog
Family or Friend
Advertisement
Social media
Email
Other