| Sandhill

This agreement is a partnership of Sandhill and Northeastern Technical College to provide broadband service to NETC students. The partnership was formed in effort to allow students to continue their education online during the COVID-19 pandemic.
If you are a NETC student and live within Chesterfield or Marlboro Counties, please fill out form below.
Student Name*
First Last
Please upload a copy of current student ID card or student schedule:*
Accepted file types: pdf, docx, jpg, jpeg, png, tiff, gif.
Email*
Best Contact Phone Number*
Is the Homeowner/Parent/Guardian a current Sandhill Customer?*
Homeowner/Parent/Guardian Name
First Last
Name on Sandhill Account*
First Last
Last 4 of Social Security Number for verification*
Sandhill Phone Number or Account Number*
Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Address*
Same as physical address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Homeowner/Parent/Guardian Social Security Number*
Homeowner/Parent/Guardian DL Number*
Homeowner/Parent/Guardian DL State*
Date of Birth*
Date Format: MM slash DD slash YYYY
Consent*
I agree that the student's name you submit does live in your household. By typing and signing your name below, you agree this is an electronic signature.
Name*
First Last