Adult Learner Remote Learning Preparedness Form

Full Name Email Address Phone Number Do you have access to a computer, laptop, or tablet for remote learning? Yes No Sometimes Do you have reliable internet access at home? Yes No Sometimes Do you have a quiet place to participate in remote classes? Yes No Sometimes Do you have any daytime responsibilities (children, work, etc) that could affect your participation? Yes No Maybe How comfortable are you with using online learning platforms? Very Comfortable Somewhat Comfortable Not Comfortable Would you like training or support to improve your technology skills? Yes No Maybe Please share anything else we should know to support your remote learning experience: