Home Internet Service Request

Home Internet Service Request

Please complete this form only if you have a child or children enrolled in Morgan County Schools (WV) and you would like to apply for free Internet service. Application approval will based on financial need.*
*Please note that applying for and being approved does not guarantee that Morgan County Schools can provide service to your home. It is possible that no Internet service is available at your location.

Funding is limited! Please submit your application as soon as possible.
Full Name *

First Name Last Name
Full Address (you must include your physical address) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number(so we can contact you) *
Please enter a valid phone number.
Email *
example@example.com
How many people are in your household? *
How many in your household are currently Morgan County students? *
What is your average annual household income? *
Please used combined income if more than one income earner lives in the home (i.e. spouse)
We will need a copy of your Form 1040. We cannot process your application without a copy of your Form 1040.

Your AGI (Adjusted Gross Income) can be found on line 8b of your Form 1040. You must use your 2019 federal tax return.
There are three options to submit a copy of your 2019 Federal 1040 form:
1. If you are using your cell phone/tablet/laptop with a camera to complete this form, take a photo by clicking on "Take Photo" in OPTION1 below.
2. If you are using your desktop computer to complete this form, you can use your cell phone/tablet to take a picture of your 2019 Form 1040 and email it to yourself. Download the picture to your computer then upload using OPTION 2 below.
3. Mail or drop-off a copy of your 2019 Form 1040 to:
  
  Morgan County Schools
  Attn: Tom Shade, Director of Technology
  247 Harrison Ave.
  Berkeley Springs, WV 25411
Option 1) TAKE A PHOTO of page 1 of your 2019 Form 1040. *
Option 2) UPLOAD page 1 of your 2019 Form 1040.

Cancel of
Do you currently have a working mobile or cell phone? *

Yes, I do No, I do not
If you have a mobile or cell phone, who is your carrier? *

AT&T Cricket Sprint T-Mobile Trac Phone US Cellular Verizon Wireless Other
Can you make calls and connect to the Internet at home using your mobile or cell phone? *

Yes No
Do you have other Internet service in your home ? (i.e. Comcast, Frontier Comm, Morgan Wireless, etc.) *

Yes, I do No, I do not
If you answered YES to the question above, who is your Internet Service Provider *

Blazing Hog (Obitco) Comcast Frontier Communications HughesNet (Satellite) Morgan Wireless Viasat (Satellite) Dish (Satellite) Other
Please explain the challenges you face in providing Internet for your child’s education (i.e. performance is too slow, often disconnects, Internet is often down, etc.): *
By signing and submitting this form I agree that all of the above statements are true and accurate.

Please sign below then click or tap on SUBMIT.
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Home Internet Service Request

We will need a copy of your Form 1040. We cannot process your application without a copy of your Form 1040.

There are three options to submit a copy of your 2019 Federal 1040 form:

By signing and submitting this form I agree that all of the above statements are true and accurate.