HASD WiFi Request Form

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Please fill out the following information to request a WiFi Hot Spot from the district to use during remote learning protocol. Fill out with the youngest student's info. Only 1 device per household will be provided. The WiFi hot spots use T-Mobile cellular data connections to operate, coverage may vary depending on location. Each device has a customer support number listed on them if needed.

If you still have a device that was issued last year you will not receive a new one.

You will be notified when to pick up hotspot after your request has been reviewed and approved.

Student Name *

Student ID *

Parent/Guardian Name *

Parent/Guardian Email *

Phone number *

Number of Students in Household *

Device Loan Agreement *

By checking this box I agree this device will be added to the HASD Student Device Agreement on file with the district.

I have read the HASD Acceptable Use Policy "AUP" that was provided with the student chromebook.

The device will be returned to the district at the end of the remote learning period or upon the students exit from the district.

Required

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