Internet Access at Home
In an effort to better serve our patrons and students, please fill out this form to give us as much information around your home internet situation. This info will help us understand and better tailor our efforts to provide equal education to all students.
* Required
Date
*
MM
/
DD
/
YYYY
Parent/Guardian First Name
*
Your answer
Parent/Guardian Last Name
*
Your answer
Name of attending student(s). Please list all students you have attending Pocahontas School District.
*
Your answer
What school(s) will your student attend for the upcoming school year?
*
ALMA
MDW
PJHS
PHS
Required
What grade(s) for the upcoming school year?
*
K
1
2
3
4
5
6
7
8
9
10
11
12
Required
Do you have access to the internet at home?
*
Yes
No
Who is your service provider?
*
Choose
Suddenlink
CenturyLink
Verizon
AT&T
HughesNet
Clay County Electric
Other
I do not have internet access at my home
Do you have Cell Phone service at home?
*
Yes
No
If you have Cell Phone service at home, who is the provider?
*
Choose
Verizon
AT&T
T-Mobile
Sprint
I do not have Cell Phone service at my home
I have cell service, but it is not listed
If you do not have internet access/cell phone service at home, are you able transport your child to a location with internet service? (i.e., school parking lot, family, friend)
*
Yes
No
Submit
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