1. How often do you use computer devices, such as desktops, laptops, or tablets, in class?

2. Do you have a school-provided computer device, such as a laptop or tablet?

3. Answer the following questions.

Do you personally own a desktop computer?
Yes, and I'm the only user.
Yes, and I share it.
No.
Do you personally own a laptop, such as a Chromebook or MacBook?
Yes, and I'm the only user.
Yes, and I share it.
No.
Do you personally own a tablet, such as an iPad or Nexus?
Yes, and I'm the only user.
Yes, and I share it.
No.

4. Answer the following questions.

Do you personally own a smartphone, such as an iPhone or Samsung Galaxy?
Yes, and I'm the only user.
Yes, and I share it.
No.
Do you personally own an e-Reader, such as a Kindle?
Yes, and I'm the only user.
Yes, and I share it.
No.

5. Answer the following questions.

Do you personally own an MP3 player that is not part of a smartphone, like an iPod?
Yes, and I'm the only user
Yes, and I share it
No
Do you personally own a digital camera that is not part of a smartphone, such as a Vtech or Fisher Price camera?
Yes, and I'm the only user.
Yes, and I share it.
No.

6. Can you get on the Internet at home?

7. Is your Internet at home wireless?

8. Complete the following sentences.

Sending emails is
Easy
Hard
Something I don't know how to do
Recording video is
Easy
Hard
Something I don't know how to do
Working with others in an online document, like a Google Doc, is
Easy
Hard
Something I don't know how to do
Creating spreadsheets is
Easy
Hard
Something I don't know how to do

9. Do you agree with the following statements?

I learn technology easily.
Yes, always
Sometimes
No, never
I find good solutions when I have a problem with technology.
Yes, always
Sometimes
No, never

10. Answer the following questions.

How often do you download or stream music?
Weekly
Monthly
Never
How often do you look at photos or videos online?
Weekly
Monthly
Never

11. Answer the following questions.

How often do you play games on a computer, tablet, or smartphone?
Weekly
Monthly
Never
How often do you talk to someone online, such as using Google Hangout or Facetime?
Weekly
Monthly
Never
How often do you read things on the Internet, such as blogs or news sites?
Weekly
Monthly
Never

12. Answer the following questions.

How often do your teachers ask you to use online documents, such as Google Docs?
Weekly
Monthly
Never
How often do your teachers ask you to work online with classmates?
Weekly
Monthly
Never

13. Answer the following questions.

How often do your teachers ask you to show your work to students IN class?
Weekly
Monthly
Never
How often do your teachers ask you to show your work to someone ONLINE?
Weekly
Monthly
Never
How often do your teachers ask you to chat with someone online?
Weekly
Monthly
Never

14. Answer the following questions.

How often do your teachers ask you to use a digital camera to take pictures or videos?
Weekly
Monthly
Never
How often do your teachers ask you to use computers to make presentations?
Weekly
Monthly
Never
How often do your teachers ask you to create music, movies, webcasts, or art using technology?
Weekly
Monthly
Never
How often do your teachers ask you to post your schoolwork online?
Weekly
Monthly
Never

15. Answer the following questions.

How often do your teachers ask you to do research online?
Weekly
Monthly
Never
How often do your teachers ask you to use computers to do experiments or take measurements?
Weekly
Monthly
Never
How often do your teachers ask you to use computers to gather information?
Weekly
Monthly
Never
How often do your teachers ask you to use computers to graph, chart, or organize information?
Weekly
Monthly
Never
How often do your teachers ask you to solve real-life problems using technology?
Weekly
Monthly
Never

16. Answer the following questions.

How often do your teachers teach you how to report where you find information online, such as videos, news articles, or pictures?
Weekly
Monthly
Never
How often do your teachers teach you how to share information about yourself online?
Weekly
Monthly
Never
How often do your teachers teach you how to act respectfully online?
Weekly
Monthly
Never
How often do your teachers teach you how to respond to online bullying?
Weekly
Monthly
Never

17. Do you agree with the following statements?

Technology in the classroom helps me learn.
Yes, always
Sometimes
No, never
I pay more attention when we use technology in class.
Yes, always
Sometimes
No, never
I think computers and technology make my life better.
Yes, always
Sometimes
No, never

18. What grade are you in?