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Whirlie Device and Access Survey - December 2020
Please complete the form below to provide us with updated information on your device and access needs. We will use this information to help us as we get devices in.
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* Indicates required question
Student Name
*
Your answer
Grade Level
*
9th
10th
11th
12th
Parent/Guardian Name
*
Your answer
Phone Number - what is working phone number that we can reach you at when we have a device to give you?
*
Your answer
Do you currently have a device?
*
Yes
Yes - that is shared with someone else
No
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