Student Hotspot Request Form
This form is used to request equipment from Chester Upland School District
In an effort to ensure all Chester Upland School District students have access to the Internet and are able to attend school remotely, the District will provide mobile Hot Spot devices to families without Internet. Note:  The mobile Hot Spot is not regular Internet.  

The Hot Spot only works with Chester Upland School District computers, and it will only provides Internet access to school approve websites and online curriculum not the entire Internet.  Students will not be able to access online games, music, movies or social media using the mobile hot spot. Non school issued laptops or devices will not be able to use the Hot Spot to access the Internet.  One Hot Spot per household will be issued.  In the event there are multiple Chester Upland students in a household, all the children who have a school issued laptop or device  will be able to access the Internet from the one Hot Spot. If you are in need of Internet access complete the form below and submit it.   Once the form is submitted you will receive an email from the District  with instructions for picking up your mobile device.  
Sign in to Google to save your progress. Learn more
Student First Name *
Student Last Name *
Student ID Number *
Parent/Guardian First Name *
Parent Guardian Last Name *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Address *
City *
Zip Code *
What School Building is/are the student/s assigned to *
Please Indicate what day/s would be best for you to pick up the device? *
Required
Please indicate what time/s would be best for you to pick up the device Monday - Friday? *
Required
Please indicate the number of school age children that reside in your household. *
If you have additional students that will be utilizing this device, please write the student's Id's, first name, and last name below separated by commas. (Example: Robert Jones, 211427) *
Check all that apply * *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Chester Upland School District. Report Abuse