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Kent ISD AT Trial Extension Request
Please complete this form if you would like to request an extension on a current trial. 
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Borrower's name *
(Last Name, First Name)
Borrower's email address *
School district/program & building (location) where equipment is currently being trialed: *
Equipment/device being trialed *
Extension requested until: *
MM
/
DD
/
YYYY
Reason for extension request: *
Do members of the team need additional technical training on the equipment? *
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