Student Internet Email Account - West Virginia Department Of Education
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1
2Year of graduation from high school:
______________
STUDENT
INTERNET EMAIL ACCOUNT
through
West Virginia Department of Education (WVDE)
West Virginia Network for Educational Telecomputing (WVNET)
Computers, networks and on-line access are used to support learning and to enhance instruction.
These tools and connections to the Internet allow communications with millions of users through
hundreds of thousands of networks. Your application for an Internet account indicates you will
comply with the attached use policies and will be a responsible, efficient and ethical user.
Failure to adhere to the policies and guidelines will result in the revocation of the use privileges.
Please answer all questions. Incomplete forms cannot be processed.
Please type or print all information .
Date(M/D/Y)_____________
Name ________________________________________________________________________
First
Middle
Last
WVEIS Number ___________________
Home Phone_______________________
9- digits
Home Address__________________________________________________________________
Street/P.O. Box
______________________________________________________________________________
City
State
Zip
School Phone______________________
School Name___________________________________________________________________
School Address_________________________________________________________________
_________________________________________________________County_______________
Please check/complete the following student information:
1. Date of Birth:(M/D/Y)_____________________
Current Grade Level:_______
2. I plan to access the Internet from _____school _____home _____other:__________________
3. I have been provided training on the appropriate use of the Internet by:
Name of trainer/teacher:____________________________ Date:(M/D/Y)_______________
Location of training:_________________________________Hours of training:___________
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