COHORT SURVEY TEMPLATE

Thistemplate is not prescriptive, it is simply there as a template
and a timesaver where needed.

If you feel that this could be improved on, do let us know, so that we can
pass on your experience and expertise to other schools.

This survey is designed to help schools research current home access, particularly in gathering data on your low income families

Depending on the type of device and the way you intend to use it, access to the internet at home may be an essential part of your plan. If this is the case you will need to ensure that you receive a response from every family and that, where the internet is not currently available, you work with the family to make appropriate provision. Your School Liaison Manager can advise you of the options available.

The survey will also help you in setting the most appropriate ‘suggested donation’ for your programme.

Please enter your suggest donation amount and the number of years in the survey
where marked in the survey form.

COHORT SURVEY TEMPLATE
Introduction letter

Dear ………………………….,

As you may have heard, we are hoping to run an exciting e-learning project to give all our students in year …… the opportunity to learn using the latest technology, both at home and at school. We as a school are committed to giving our students the best possible opportunities to learn and grow, and equip them for future employment in an increasingly digital age. One ideal way to do this would be to provide a ………. device for each student to allow access to resources to help them learn at home as well as at school.

We get no extra government funding to do this, however we will utilise some of our Pupil Premium funding specifically to help our families on lower incomes.

To help us plan the right kind of project for all our students, we want to understand what technology, if any, the children have at home. If you could fill in this short survey, and send it back to school as soon as possible (by ………… at the latest), it would help give us the best chance of gaining some charitable support and establish if we are able to run this project.

Many thanks

…………………………………………..

PUPIL HOME ACCESS SURVEY

To be returned to …………………………………………….……….. by ………………………………..

Please answer the following questions to the best of your ability (tick one box):

  1. I am interested in an opportunity for my child to have access to a school computer/learning technology to support their learning at home and at school?  Yes  No
  1. Please choose which option below best describes any internet connection you may have at home:

 Wireless broadband

Non-wireless broadband

Dial-up internet

We do not have an internet connection (*please also answer q2a)

2a.Please choose which option below best describes your home;

 Sky/Cable TV

Home land line

We do not have sky/cable or a land line.

  1. Please choose which option below best describes your child’s access to a computer:

PC shared with ……. many family members

PC for sole use

Laptop shared with ……. many family members

Laptop for sole use

We do not have a computer

  1. Please state if you feel your child would benefit from the following Assistive Technology software
    on your computer:

 Software to support literacy development, reading, writing and spelling

 Software to help learners with visual impairments access information

 Speech recognition software to control the computer and type text

 Large keyboard, special mouse or other device to help with a physical difficulty
Please specify:

......

 Other software for disabilities or to help with special education needs: please specify:

......

  1. Please indicate which areas you would like to develop in your own ICT learning?

e-safety trainingInternet trainingoffice applications

Parent portal trainingother

We are eligible for Free School MealsYes  No

In order for the programme to be able to run we will need the majority of our parents to contribute a suggested donation of £ {xxx} per month for {xxx} years as this will allow the programme to run.

Should the programme go ahead, no child will be excluded because of their family’s inability to contribute financially.

Please indicate whether you feel you could donate at the suggested amount

Could donate the suggested £…. per month

May donate the suggested £…. per month

Could donate a part of this per month – e.g. £……

We would not want donate

Signed: ______Date: ______

Parent/carer name: ______

Child’s name: ______Form: ______

Learning Foundation1Registered Charity No. 1086306