Student Laptop Loan Agreement & Checkout
By receiving this laptop/equipment from Eugene School District 4J, you agree to adhere to ECCO High School's "Acceptable Use Policy" (found below) and sign this Agreement. School laptops are issued for school-related educational activities and support.
Email address *
Student's Last Name *
Your answer
Student's First Name *
Your answer
Student's 4J-ID #
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Preferred Email Address *
Your answer
4J Email Address
Your answer
Home Address *
Your answer
Student Phone (cell) *
(example ###-###-####)
Your answer
Parent's Name
Your answer
Parent's Phone
(example ###-###-####)
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of 4j.lane.edu. Report Abuse - Terms of Service