Connect Kit Application Form

The Connect Kit includes 1 Wi-Fi hot spot with a case, 1 iPad and protective case, 2 charging blocks, 2 USB charging cords, 1 OPL branded carrying bag. These kits are designed to assist customers who experience barriers to access the internet within their homes. Borrowing guidelines are 6 weeks maximum with no renewals or holds. Total replacement cost of the Connect Kit is $665.49 and will be charged to your account should you lose or damage the kit.

Sign in to Google to save your progress. Learn more
Full Name *
Address *
City *
Postal Code *
Phone Contact *
Email *
Library Card Number *
No Library card? No problem, get one here or in person when you visit any of our four branches.
Alternate Contact Name
Optional
Alternate Contact Phone/Email
Optional
Do you have internet at home? *
Terms of Service *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy