Mobile Hotspot Application for Families

Mobile Hotspot Application for Families - Act 142

A Program by S.C. Office of Regulatory Staff (ORS)
Under Act 142, you may be eligible to receive a free internet hotspot through December 2020 under a program by S.C. Office of Regulatory Staff (ORS).

To qualify you must meet the following criteria:
1. A student of Beaufort County School District must reside in your household.
2. Households must show an income at or below 250 percent of federal poverty (see chart below)
3. There is currently no internet service in the household.
If you feel you meet these criteria and want to apply to receive a Mobile Hotspot for use for student virtual learning, please answer the following questions.
Person Completing this Form: *

First Name Last Name
Parent/Guardian Name *

First Name Last Name
Parent/Guardian Phone Number *
Please enter a valid phone number.
Parent/Guardian Email Address
example@example.com
Preferred method of contact: *

Phone Email

Based on the Federal Povery Guidelines, does your household meet this income criteria? *

Yes No
Household income exceeds guidelines.

Based on the information you provided, your household is not eligible for the Mobile Hotspot service program.

Please submit the form for our records.

Is there currently internet service in your household? *

Yes No
Your household has an existing internet service.

Based on the information you provided, your household is not eligible for the Mobile Hotspot service program.
No existing internet service due to: *

There are no internet providers currently providing coverage at the location of my household. I cannot afford the cost of internet service for my household All of the Above
IMPORTANT NOTICE: Geographic hardship alone does not qualify your household for this program. By completing your physical address below, BCSD will provide your address to ORS as they continue to advocate for the implementation of broadband across the state.
Physical Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Eligibility

Based on your answers, your household appears to meet the criteria for qualification of 1 mobile hotspot to be used for educational purposes only until December 30, 2020. By submitting this form, you certify all responses to be true and allow BCSD to verify enrollment and specifics as needed.

Mobile hotspots will be assigned to the oldest BCSD student in your household and will be issued once the devices are onsite and configured. Please ensure your contact information is current so you may be contacted for questions and pick up information.
Parent/Guardian Signature *

Or signature on behalf of Parent/Guardian Clear
Principal Signature *

Clear

Should you have any further questions, please direct them to your school social workers.

Thank you.
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Mobile Hotspot Application for Families - Act 142