Jefferson High Chromebook/HotSpot Request Form
Senate Bill 98 requires that all students have access to internet connectivity and device. Please indicate below if your student will need a Chromebook or a hot spot to connect to the internet. Please note that the Chromebook will be assigned to your student the same way school textbooks are assigned. You could pay up to $250, if the Chromebook is lost, stolen, or damaged.
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Email *
Parent/Guardian Information
The individual completing this form
Parent/Guardian First Name *
Parent/Guardian Last Name *
Student Information
Student First Name *
Student Last Name *
Student Date of Birth *
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Student School Identification Number (if known)
In the Fall 2020, my student will be in grade: *
Does the student have reliable internet connection? *
If no, we will be loaning out a hot spot to connect to the internet.
Does the student have a device to use at home for Distance Learning? *
If no, we will be issuing a Chromebook.
A copy of your responses will be emailed to the address you provided.
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