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
*
Your email
Parent/Guardian Name
Your answer
First and Last Name of student #1 (if no additional children type N/A):
Your answer
First and Last Name of student #2 (if no additional children type N/A):
Your answer
First and Last Name of student #3 (if no additional children type N/A):
Your answer
First and Last Name of student #4 (if no additional children type N/A):
Your answer
First and Last Name of student #5 (if no additional children type N/A):
Your answer
First and Last Name of student #6 (if no additional children type N/A):
Your answer
Which school(s) will your children attend for the 20-21 school year:
Cooper
Derby Hills
El Paso
Oaklawn
Park Hill
Stone Creek
Swaney
Tanglewood
Wineteer
Derby Middle School
Derby North Middle School
Derby High School
What grade levels will your children be in during the 2020-2021 school year:
Early Childhood/PreK
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Which mode of Instruction did you select during enrollment?
In-Person Learning
Remote (Online Only) Learning
Clear selection
Do you have financial means to secure your own internet for your child(ren)?
Yes
No
Clear selection
Please provide any additional information below.
Your answer
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