Student Learning Device Loan Form
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Savannah-Chatham County Public School System (SCCPSS) is providing students with a learning device to support the continuation of teaching and learning through online software and Internet resources for both at school and at home.
Student’s/Parent’s Responsibilities (including device usage at school as well as at home)
• The Learning Device is provided for the student only. Student ID and password is required to access the device.
• The student is required to practice good digital citizenship and adhere to the Acceptable Use Policy IFBG-R.
• Student/Parent agrees to use the device for learning during the period of assignment, protect the device, maintain it, and promptly return the device (including power cable) when requested.
• Learning Device will remain checked out to the student until it is returned to the issuing school. This means that the record will follow the student until the equipment has been returned in the same condition that it is issued (reasonable wear is expected).
• If the device is stolen, you are required to file a police report and notify the school. * If the device is lost, stolen, or damaged, you are responsible for repairs or replacement.
*Only applies to device that are off campus. Device stolen on campus must be reported to SCCPSS Campus Police, Administrator and Media Staff immediately.
**Students with devices still checked out or outstanding fines will not be allowed to check out a device to take home.**
Student’s Full Name:
Parent’s Full Name:
Serial Number of Device (to be completed by school representative)
Room Number of Homeroom:
By checking the box, I am accepting a learning device for my student and I agree to the Student’s/Parent’s Responsibilities stated above.
By checking the box, I am declining a learning device for my student for SY 21-22. I fully understand that this means that my student will be issued a device to use at school but will NOT be issued a device to take home. Furthermore, I agree to the Student’s/Parent’s Responsibilities stated above as they apply to devices used only at school.
I DECLINE a take-home device.
By checking the box, I am declining a device be issued to my student. I fully understand that this means that I must provide a device for my student to use at school and at home. I am also aware that since a personal device cannot be added to the SCCPSS network that some applications and websites may not be accessible by my student on a personal device. In some instances, a school loaner device may need to be issued for in school use on a temporary basis. I understand that I am agreeing to the Student’s/Parent’s Responsibilities stated above as they apply to devices used only at school.
I agree to provide a device for my student to use at school and at home.
Family Protection Plan (FPP) for Parents and Students
SCCPSS is offering a family protection plan to offset repairs and/or replacement for the technology device that will be issued to students. A one-time, non-refundable, charge of $25* will cover 2 incidents of accidental damage or up to 2 device replacements for the school year 2021-2022. Without the plan, parents/guardians are responsible for the full cost of repairs and/or replacement costs as stipulated in Administrative Regulation ECH-R: Authorized Uses of Equipment and Supplies. The Family Protection Plan must be purchased within 10 days after receiving the device.
See the table below for current pricing of repair parts:
I accept the Family Protection Plan for my student’s device and will pay $25 when submitting this form to the school. (Schools will define payment process.) By checking the box, I agree to purchase the FPP (Family Protection Plan) for $25 (not to exceed $100 for families with over 4 students in SCCPSS schools). I understand that I will need to follow the link below or go directly to my student’s school website and choose to pay for the FPP through SchoolCashOnline. I understand that all previously purchased TPP has expired. I understand that I have 10 business days to make payment upon receipt of the device.
I ACCEPT the Family Protection Plan for my student's device.
By checking the box below, I understand that I am declining FPP (Family Protection Plan) and I am therefore responsible for all damages or replacements of my student’s device for SY 21-22.
I DECLINE Family Protection Plan for my student's device.
My typed name below serves as my signature and verification of the responses given in this form. (Parent's name)
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Savannah Chatham Public School System.