Request for Internet Connection/Internet Service Provider/Computer

Please fill out this form to request Internet Connection to your residence, Internet Service to a residence with an existing internet connection, and/or for a free or reduced cost laptop computer or computer tablet.

(8000 character limit. Characters so far: 0 Word Count: 0)

Do you currently have internet service?

If you don't have internet- why?

Service Requested

Can you pay any amount for a new computer/laptop?

Please review what you entered before you click the Submit button, and click it ONLY ONCE.