WiFi Hot Spot Request Form for 2021-2022 School Year
If you are a needing WiFi assistance to support student learning during quarantine, please complete the survey questions below for your family. The Wifi hotspots will only be approved if you were sent a close contact letter from the school district. We will use the request submitted here to review family eligibility for a district or grant supported hot spot device. An email will be sent to verify if your request is able to be met.

Additional opportunities for free or reduced WIFI service can be found at this website: getemergencybroadband.org
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Email *
Parent/Guardian Name
First and Last Name of student #1 (if no additional children type N/A):
First and Last Name of student #2 (if no additional children type N/A):
First and Last Name of student #3 (if no additional children type N/A):
First and Last Name of student #4 (if no additional children type N/A):
First and Last Name of student #5 (if no additional children type N/A):
First and Last Name of student #6 (if no additional children type N/A):
Which school(s) will your children attend for the 20-21 school year:
What grade levels will your children be in during the 2020-2021 school year:
Which mode of Instruction did you select during enrollment?
Clear selection
Do you have financial means to secure your own internet for your child(ren)?
Clear selection
Please provide any additional information below.
Submit
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