SmMS Chromebook & Hotspot Request Form
In order to request a school Chromebook or hotspot, this form should be completed by a parent or guardian. If you have more than one child attending Smithfield Middle School, please complete this form for each child that needs a device. In order to receive a device, this form must be completed. The school will not distribute a device without completing this form. You will receive an email regarding when you are able to come to Smithfield Middle to pick up the device.
Email address *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Phone Number *
Student's First Name *
Student's Last Name *
Student's Grade Level *
Student's PowerSchool Number or Student ID
Does your student need a Chromebook? (Note: Details regarding device pick up will be emailed to you after you submit the form.) *
Does your student need a hotspot for internet access? (Note: Details regarding hotspot pick up will be emailed to you. Hotspots are based on district availability.) *
JCPS Home Use Technology Loaner Agreement
JCPS Home Use Technology Loaner Agreement
By submitting this form, you are stating that you have read and agree to the terms of usage provided in the JCPS Home Use Technology Loaner Agreement. *
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