Chromebook Charger Request
Please complete this form to request a new Chromebook charger if yours is lost or not working.
**Salem Middle School students only**
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Email *
Student ID number *
Identificación del Estudiante
Grade and Track *
Grado y ciclo
Student First Name *
Nombre del estudiante
Student Last Name *
Apellido del estudiante
Reason for needing a charger *
Parent/Guardian Email *
Correo electrónico del padre, madre o tutor legal
Parent/Guardian First Name *
Nombre del padre, madre o tutor legal
Parent/Guardian Last Name *
Apellido del padre, madre o tutor legal
Phone number *
Teléfono
Submit
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