Hot Spot Request Form
For those families who do not have internet access for their child(ren) to complete school work at home,  Imagine Rosefield has a limited supply of AT&T wi-fi hotspots that were funded through the Emergency Connectivity Fund (ECF). The school has a limited number of devices for loan. The device will be on loan from Imagine Schools, to the student listed on this request for educational use outside of school. Any other use will not be authorized. To receive a device on loan, a parent or guardian must complete a User Agreement form (in addition to this online request form) indicating they will assume full responsibility for the device and agree to pay a $50 replacement fee or the cost of any repairs at an amount less than $50. This online form serves the purpose of requesting a device only. Upon request, parents will receive pick-up information. During pick-up of the device, the aforementioned User Agreement will be required.  
Sign in to Google to save your progress. Learn more
Student Name *
Student Grade *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy