Internet Equipment Access Form

Internet Equipment Access Form

Jetpack or Wireless Router using Verizon Network
A Jetpack (seen below image) is a small device tha allows devices to connect to it for WiFi internet access. Can connect up to 10-15 devices. You can charge the battery for it to be portable.
A Wireless Router (seen below image) is a small device tha allows devices to connect to it for WiFi internet access. Can connect up to 200+ devices. Device must be plugged into power (AC adapter) at all times with antennas connected as illustrated in below image.
Check-Out Terms & Agreement
- Equipment can be checked out for at most, 2 months at a time
- While in your care, you are responsible for the security, maintenance and cleanliness of equipment
- All equipment and peripherals are to be returned
- IT will evaluate to ensure no abuse of equipment useage
- WiFi password will be communicated to the user when equipment is checked-out
- When not in use, please make sure to haev equipment in a secure place to prevent theft
- Equipment will only be used for work related purpose only
Today's Date*

MonthDayYear
Date
Anticipated Equipment Return Date*

MonthDayYear
Date
Requested Equipment*

JetpackRouter
Your Name*

First NameLast Name
Your Email*
MUST BE A Kama‘aina Kids WORK EMAIL
Your Phone Number*
Please enter a valid phone number.
Purpose of Internet Access Needed*
Should be Empty: