* Required

Parents, 

Please fill out one technology survey for your family. 

Parent's First Name*required

Parent's Last Name*required

Child 1

Student's First Name*required

Student's Last Name *required

School *required

Please Select…Breaux Bridge PrimaryBreaux Bridge ElementaryBreaux Bridge Jr. HighBreaux Bridge High SchoolCatahoula ElementaryCecilia PrimaryTeche ElementaryCecilia Jr. HighCecilia High SchoolParks PrimaryParks Middle SchoolEarly Learning CenterSt. Martinville PrimarySt. Martinville Jr. HighSt. Martinville Sr. HighStephensville Elementary

Grade Level *required

Please Select…Pre-KKindergarten123456789101112

Student ID

This number can be found in the parent command center.

Child 1 has a device they can use at home for virtual learning.

Yes  No 

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Child 2 

Student's First Name

Student's Last Name

School

Please Select…Breaux Bridge PrimaryBreaux Bridge ElementaryBreaux Bridge Jr. HighBreaux Bridge High SchoolCatahoula ElementaryCecilia PrimaryTeche ElementaryCecilia Jr. HighCecilia High SchoolParks PrimaryParks Middle SchoolEarly Learning CenterSt. Martinville PrimarySt. Martinville Jr. HighSt. Martinville Sr. HighStephensville Elementary

Grade Level

Please Select…Pre-KKindergarten123456789101112

Student ID

This number can be found in the parent command center.

Child 2 has a device at home they can use for virtual learning.

Yes  No 

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Child 3

Student's First Name

Student's Last Name

School

Please Select…Breaux Bridge PrimaryBreaux Bridge ElementaryBreaux Bridge Jr. HighBreaux Bridge High SchoolCatahoula ElementaryCecilia PrimaryTeche ElementaryCecilia Jr. HighCecilia High SchoolParks PrimaryParks Middle SchoolEarly Learning CenterSt. Martinville PrimarySt. Martinville Jr. HighSt. Martinville Sr. HighStephensville Elementary

Grade Level

Please Select…Pre-KKindergarten123456789101112

Student ID

This number can be found in the parent command center.

Child 3 has a device at home they can use for virtual learning.

Yes  No 

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Child 4

Student's First Name

Student's Last Name

School

Please Select…Breaux Bridge PrimaryBreaux Bridge ElementaryBreaux Bridge Jr. HighBreaux Bridge High SchoolCatahoula ElementaryCecilia PrimaryTeche ElementaryCecilia Jr. HighCecilia High SchoolParks PrimaryParks Middle SchoolEarly Learning CenterSt. Martinville PrimarySt. Martinville Jr. HighSt. Martinville Sr. HighStephensville Elementary

Grade Level

Please Select…Pre-KKindergarten123456789101112

Student ID

This number can be found in the parent command center.

Child 4 has a device at home they can use for virtual learning.

Yes  No 

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Child 5

Student's First Name

Student's Last Name

School

Please Select…Breaux Bridge PrimaryBreaux Bridge ElementaryBreaux Bridge Jr. HighBreaux Bridge High SchoolCatahoula ElementaryCecilia PrimaryTeche ElementaryCecilia Jr. HighCecilia High SchoolParks PrimaryParks Middle SchoolEarly Learning CenterSt. Martinville PrimarySt. Martinville Jr. HighSt. Martinville Sr. HighStephensville Elementary

Grade Level

Please Select…Pre-KKindergarten123456789101112

Student ID

This number can be found in the parent command center.

Child 5 has a device at home they can use for virtual learning.

Yes  No 

---

Child 6

Student's First Name

Student's Last Name

School

Please Select…Breaux Bridge PrimaryBreaux Bridge ElementaryBreaux Bridge Jr. HighBreaux Bridge High SchoolCatahoula ElementaryCecilia PrimaryTeche ElementaryCecilia Jr. HighCecilia High SchoolParks PrimaryParks Middle SchoolEarly Learning CenterSt. Martinville PrimarySt. Martinville Jr. HighSt. Martinville Sr. HighStephensville Elementary

Grade Level

Please Select…Pre-KKindergarten123456789101112

Student ID

This number can be found in the parent command center.

Child 6 has a device at home they can use for virtual learning.

Yes  No 

Do You have internet (wifi) at home?*

Yes  No