RSA Digital Device Application YR18-19
We understand that not everyone is able to provide a digital device for their student. We have a *limited* quantity of devices that we can loan to RSA students for the 2018-2019 school year. The student is responsible to use the device competently and with care.

Damages from external causes such as accident, abuse, misuse, and theft is the financial responsibility of the parent or guardian. It is *highly recommended* the parents or guardians requesting a device for their student purchase a digital device insurance policy (more information on the school website). If you would like to request a digital device for your student complete the application below.

Keep in mind that it will take 1-2 days to be notified that the loaner device is ready for pick up by a parent/guardian.

Thank you.
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Student First Name *
Your answer
Student Last Name *
Your answer
Grade *
Student ID *
Ex: 222123 (lunch number)
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Phone Number *
999-123-4567
Your answer
Parent/Guardian Email Address *
Your answer
I understand that I will need to read a device release form in order to complete this registration process. *
Required
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