Family Hotspot Checkout Application

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This application is for requesting a hotspot.

𝐄𝐥𝐢𝐠𝐢𝐛𝐢𝐥𝐢𝐭𝐲
1. Student lunch status is free/reduced.
2. Student does not have access to internet at home.
3. Student does not have access to internet due to other circumstances.

The Kajeet hotspot allows your child to safely complete school homework and assignments using the internet. The hotspot provides filtered mobile broadband connectivity to a 4G network so students can safely access the internet while at home. When using the hotspot, the Chromebook is filtered specifically for school assignment use; inappropriate and non-education content and cannot be accessed.

When the application is approved, your child will be able to check-out a hotspot through the Media Center/Learning Commons.

𝐈𝐧𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧
1. The hotspot is the property of Crown Point Community School Corporation.
2. The school principal or designee reserves the right to revoke the hotspot privilege from the student.
3. Complete and application for each child.
4. Only one hotspot may be checked out per student.

Email *

Student First Name *

Student Last Name *

School *

Grade *

Explain why there is no internet at home. *

I have read the CPCSC Network and Internet Acceptable Use Policy and Safety Agreement and agree to follow all terms and conditions. https://drive.google.com/file/d/0B8AgiT5iz_VpRzNlUUowNGhpUWs/view?usp=sharing&resourcekey=0-A0YDC1TxQLjf79-YcakekA *

I agree.

Required

𝐒𝐭𝐮𝐝𝐞𝐧𝐭 𝐚𝐧𝐝 𝐏𝐚𝐫𝐞𝐧𝐭 𝐀𝐠𝐫𝐞𝐞𝐦𝐞𝐧𝐭 *

By checking the boxes below, I agree to the hotspot use criteria:

I am the only user and completely responsible for its safety and use.

I am responsible for the cost of any damage or loss that results from accident, theft, misuse or neglect.

I will use the hotspot in a responsible manner.

I will not attempt to or download or install any applications, extensions or files onto my device.

I will immediately report any loss or damage of the hotspot to the Media Center.

I will not attempt to fix the hotspot.

Required

By submitting this form you agree to the terms of the application.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Crown Point Community Schools.

Does this form look suspicious? Report

Forms