Connectivity Request
Please fill out if you need internet access (MIFI) for student learning.
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Email *
Do you need connectivity for school related work at home?
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Is your student returning from the 2019/2020 school year?
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Did your student receive WIFI during the 19/20 school year?
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If yes, has the connectivity device been returned? (these devices need to be returned as they will no longer work)
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Student Name
Grade
Primary Contact Name
Primary Phone Number
Secondary Contact Name
Secondary Phone Number
Number living within household
What is your annual household income?
Address you are requesting service
Do you need service at a secondary address? If so please give secondary address.
Shipping Address (where you want the device mailed to)
Does your student require service at more than 2 addresses?
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Parent Consent: I (parent/guardian) hereby certify the information provided is accurate. Additionally I understand that the device remains the property of the Anchorage School District. I agree to abide by the school district's policies regarding the care and proper use of district devices.
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