Technology Check-out Form
Please complete ALL questions before submitting this form if you would like to make arrangements to checkout a device from the Weiser School District. A reliable WiFi connection or hot-spot is required to gain access to the online-educational resources that have been made available by your child's teacher(s). WiFi access is available at all WSD school buildings and can be acquired from the parking lot.
Email address *
Date *
Student's Name (first and last) *
Your answer
Parent's/Guardian's Name (first and last) *
Your answer
Please provide a phone number where you can be reached so that a pick-up time can be scheduled. *
Your answer
Student's Current School *
By answering "YES" to this question, we acknowledge that student use of this device is governed under the provisions of the Weiser School District Technology Consent and Waiver and District Policy 704: Computer and Internet Use. Students and their parents/guardians are required to sign this Waiver each school year prior to using technology in the WSD. *
By answering "Yes" to this question we acknowledge that we are taking financial responsibility for replacement or repair to the device that has been checked out to us if it is lost or damage while in our care. *
Never submit passwords through Google Forms.
This form was created inside of Weiser Schools. Report Abuse