This document contains a questionnaire for teachers regarding their use of technology in mathematics instruction. It has four sections: (1) demographic information of teacher respondents, (2) available technologies used in the classroom, (3) use of technology to facilitate teaching and learning, and (4) application of ICT skills by teachers in teaching mathematics. Teachers are asked to rate their familiarity with and use of various technologies like computers, software, internet, and their confidence in skills like word processing, presentations, spreadsheets, and databases. They are also asked to identify obstacles to successfully integrating technology.