Student Laptop Agreement
2019-2020 School Year
Email address *
STUDENT INFORMATION
Student Last Name *
Your answer
Student First Name *
Your answer
Student Grade *
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name(s) *
Your answer
Address *
Your answer
Phone# *
Your answer
PAYMENT INFORMATION
The use of a RSU#34 issued laptop requires a $25 fee. You have the option of paying the fee by, check or cash.

Check or cash payments must be dropped off in the Student Services Office at Old Town High School before the laptop will be issued.
Do you have more than one student enrolled in RSU 34 for grades 7 - 12?
If yes, please list their name & grade. There is a maximum fee of $50 per family
Your answer
AGREEMENT
By signing below Parents/Guardians agree to all the policies in the laptop agreement form. Printed copies are available at the high school or can be found at: tinyurl.com/yxjnaa9z
PARENT/GUARDIAN SIGNATURE (Type Full Name) *
Your answer
All student laptops can go home unless the box below is checked. Parents can revoke the privilege to take the device home at any point.
A copy of your responses will be emailed to the address you provided.
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