OP: Consumer Technology Inventory Survey

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Individual Program Student

Name of individual*

First Name

Last Name

Department / Program name*

Does the individual currently have internet access?*

Yes, using and paying for their own internet Yes, using the program's shared internet No

Infrastructure details

Name of internet service provider

Internet plan name

Internet type

Please go to https://www.speedtest.net while on the internet connection you have stated above, press "Go", and perform a speed test.

Enter the the "Ping", "Download" and "Upload" numbers below.

Finally, please copy and paste the results address link (it will look something like: https://www.speedtest.net/result/9361952395)

Ping*

in ms

Download speed*

in Mbps

Upload speed*

in Mbps

Results link

Current Equipment Inventory

Do you own the following computer equipment?*

Do you own the following computer equipment?
	Windows PC	Apple Mackintosh	None
Desktop	Do you own the following computer equipment?: Desktop (Windows PC)	Desktop (Apple Mackintosh)	Desktop (None)
Laptop	Laptop (Windows PC)	Laptop (Apple Mackintosh)	Laptop (None)

Check all that applies

Do you own the following mobile equipment?*

Do you own the following mobile equipment?
	Apple iOS	Android	None
Tablet	Do you own the following mobile equipment?: Tablet (Apple iOS)	Tablet (Android)	Tablet (None)
Smartphone	Smartphone (Apple iOS)	Smartphone (Android)	Smartphone (None)
Wearable (eg: Smartwatch)	Wearable (eg: Smartwatch) (Apple iOS)	Wearable (eg: Smartwatch) (Android)	Wearable (eg: Smartwatch) (None)

Check all that applies

Do you own the following gaming consoles?

Microsoft Xbox One Nintendo Switch Sony PlayStation 4 (PS4) None

Other:

Check all that applies

Do you own the following streaming / smart TV devices?

Amazon FireTV Android TV box/dongle Apple TV Roku TV Stick None

Other:

Check all that applies

Service Inventory

TV / Streaming service

TV / Streaming service
	I currently use this	I have this, but need help	I don't know what this is	I want this service
Traditional cable / satellite TV	TV / Streaming service: Traditional cable / satellite TV (I currently use this)	Traditional cable / satellite TV (I have this, but need help)	Traditional cable / satellite TV (I don't know what this is)	Traditional cable / satellite TV (I want this service)
Netflix	Netflix (I currently use this)	Netflix (I have this, but need help)	Netflix (I don't know what this is)	Netflix (I want this service)
Amazon Prime Video	Amazon Prime Video (I currently use this)	Amazon Prime Video (I have this, but need help)	Amazon Prime Video (I don't know what this is)	Amazon Prime Video (I want this service)
Disney+	Disney+ (I currently use this)	Disney+ (I have this, but need help)	Disney+ (I don't know what this is)	Disney+ (I want this service)
Apple TV+	Apple TV+ (I currently use this)	Apple TV+ (I have this, but need help)	Apple TV+ (I don't know what this is)	Apple TV+ (I want this service)
Other TV / Streaming service not listed above	Other TV / Streaming service not listed above (I currently use this)	Other TV / Streaming service not listed above (I have this, but need help)	Other TV / Streaming service not listed above (I don't know what this is)	Other TV / Streaming service not listed above (I want this service)
None	None (I currently use this)	None (I have this, but need help)	None (I don't know what this is)	None (I want this service)

Other TV / Streaming service not listed above

Enter the name of the social media platform

Social Media / Communication service*

Social Media / Communication service
	I currently use this	I have this, but need help	I don't know what this is	I want this service
Traditional phone / TTY	Social Media / Communication service: Traditional phone / TTY (I currently use this)	Traditional phone / TTY (I have this, but need help)	Traditional phone / TTY (I don't know what this is)	Traditional phone / TTY (I want this service)
T911	T911 (I currently use this)	T911 (I have this, but need help)	T911 (I don't know what this is)	T911 (I want this service)
Canada VRS	Canada VRS (I currently use this)	Canada VRS (I have this, but need help)	Canada VRS (I don't know what this is)	Canada VRS (I want this service)
IP Relay	IP Relay (I currently use this)	IP Relay (I have this, but need help)	IP Relay (I don't know what this is)	IP Relay (I want this service)
Facetime	Facetime (I currently use this)	Facetime (I have this, but need help)	Facetime (I don't know what this is)	Facetime (I want this service)
Skype	Skype (I currently use this)	Skype (I have this, but need help)	Skype (I don't know what this is)	Skype (I want this service)
Facebook	Facebook (I currently use this)	Facebook (I have this, but need help)	Facebook (I don't know what this is)	Facebook (I want this service)
Twitter	Twitter (I currently use this)	Twitter (I have this, but need help)	Twitter (I don't know what this is)	Twitter (I want this service)
Instagram	Instagram (I currently use this)	Instagram (I have this, but need help)	Instagram (I don't know what this is)	Instagram (I want this service)
Whatsapp	Whatsapp (I currently use this)	Whatsapp (I have this, but need help)	Whatsapp (I don't know what this is)	Whatsapp (I want this service)
iMessage	iMessage (I currently use this)	iMessage (I have this, but need help)	iMessage (I don't know what this is)	iMessage (I want this service)
Glide	Glide (I currently use this)	Glide (I have this, but need help)	Glide (I don't know what this is)	Glide (I want this service)
SMS / MMS	SMS / MMS (I currently use this)	SMS / MMS (I have this, but need help)	SMS / MMS (I don't know what this is)	SMS / MMS (I want this service)
Other social media / communication service not listed above	Other social media / communication service not listed above (I currently use this)	Other social media / communication service not listed above (I have this, but need help)	Other social media / communication service not listed above (I don't know what this is)	Other social media / communication service not listed above (I want this service)
None	None (I currently use this)	None (I have this, but need help)	None (I don't know what this is)	None (I want this service)

Other social media service not listed above

Enter the name of the social media platform

Gaming service

Gaming service
	I currently use this	I have this, but need help	I don't know what this is	I want this service
Xbox Live	Gaming service: Xbox Live (I currently use this)	Xbox Live (I have this, but need help)	Xbox Live (I don't know what this is)	Xbox Live (I want this service)
Playstation PSN	Playstation PSN (I currently use this)	Playstation PSN (I have this, but need help)	Playstation PSN (I don't know what this is)	Playstation PSN (I want this service)
Nintendo Switch Online	Nintendo Switch Online (I currently use this)	Nintendo Switch Online (I have this, but need help)	Nintendo Switch Online (I don't know what this is)	Nintendo Switch Online (I want this service)
Apple Arcade	Apple Arcade (I currently use this)	Apple Arcade (I have this, but need help)	Apple Arcade (I don't know what this is)	Apple Arcade (I want this service)
Steam	Steam (I currently use this)	Steam (I have this, but need help)	Steam (I don't know what this is)	Steam (I want this service)
Other online gaming service not listed above	Other online gaming service not listed above (I currently use this)	Other online gaming service not listed above (I have this, but need help)	Other online gaming service not listed above (I don't know what this is)	Other online gaming service not listed above (I want this service)
None	None (I currently use this)	None (I have this, but need help)	None (I don't know what this is)	None (I want this service)

Other online gaming service not listed above

Enter the name of the social media platform

Productivity tools*

Productivity tools
	I currently use this	I have this, but need help	I don't know what this is	I want this service
Word	Productivity tools: Word (I currently use this)	Word (I have this, but need help)	Word (I don't know what this is)	Word (I want this service)
Excel	Excel (I currently use this)	Excel (I have this, but need help)	Excel (I don't know what this is)	Excel (I want this service)
Powerpoint	Powerpoint (I currently use this)	Powerpoint (I have this, but need help)	Powerpoint (I don't know what this is)	Powerpoint (I want this service)
Email (Gmail, Hotmail, Yahoo Mail, etc.)	Email (Gmail, Hotmail, Yahoo Mail, etc.) (I currently use this)	Email (Gmail, Hotmail, Yahoo Mail, etc.) (I have this, but need help)	Email (Gmail, Hotmail, Yahoo Mail, etc.) (I don't know what this is)	Email (Gmail, Hotmail, Yahoo Mail, etc.) (I want this service)
Other productivity tools not listed above	Other productivity tools not listed above (I currently use this)	Other productivity tools not listed above (I have this, but need help)	Other productivity tools not listed above (I don't know what this is)	Other productivity tools not listed above (I want this service)
None	None (I currently use this)	None (I have this, but need help)	None (I don't know what this is)	None (I want this service)

Other productivity tools not listed above

Enter the name of the social media platform