JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Worthington School District - Mobile HotSpot Sign Up
One form per student is required.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student Name
*
Your answer
Parent/Guardian Name
*
Your answer
Parent/Guardian Email (if no email indicate "no email")
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Reasons for Signing Up (check all that apply)
*
Live in an area that does not have ANY broadband internet service at home
Home internet service is not ADEQUATE for school work
Waiting for my Town to finish installing broadband internet service to my home
Cost of service preventing me from getting high speed internet at home
Home internet connection slow when more than one person is using it at the same time
Primarily have to use a cell phone for internet access
Other:
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hampshire Regional School District.
Report Abuse
Forms
