Technology Check Out Form

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An iPad (grades K-5) or a MacBook (grade 6) is being loaned to your child to assist him/her in continuing his/her education during this time. This form must be completed before picking up your son's/daughter's device. Once forms have been submitted, our technology staff will prepare the device. A schedule will be developed and once it has been finalized it will be communicated so that you can pick up the device and other material the student may need to complete academic activities assigned by his/her teacher.

Parent's/Guardian's Last Name *

Parent/Guardian's First Name *

Parent Phone Number *

Parent Email *

Grade *

Kindergarten

1st

2nd

3rd

4th

5th

6th

Student Last Name *

Student First Name *

School *

Neosho Rapids Elementary

Olpe Elementary

Hartford Jr./Sr. High School

Please check the appropriate item below indicating you agree to the terms of this agreement. If you do NOT agree, check "I do NOT agree" and/or "My child has access to another device." Your child will not receive a device. If your child does not receive/have a device, your child's education will be delivered through an alternative method to be determined by his/her teacher. *

I understand this device is being loaned to the student for educational purposes only during the spring 2020 Continuous Learning term; I understand that I am responsible for the cost of replacement or repair of the device for any loss. I understand that in the event of damage to the device the student and/or parent are responsible.

I do NOT agree to the terms of this agreement.

My child has access to another device and will not need to use a school issued device (I understand that certain apps may not be available for my child, should I choose to use our own device.)

Required

Parent/Guarding Initials (indicates agreement of terms)

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