Technology Form 20-21
All student users will be required to sign an acknowledgement of Board of Education Policy #7315 Student Use of computerized Information Resources (Acceptable Use Policy) and Policy #7316 Use of Electronic Devices by Students, and the District's Guidelines for the use of District and Personal Technology before establishing an account or continuing in his/her use of  email.  
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Student Last Name *
Student First Name *
Student Grade *
Student:  I acknowledge that I have received and read a copy of  Policy #7315 and the District Guidelines for the Use of District and Personal Technology.   *
Please type your first and last name in the box below. Typing your name in the box constitutes your electronic signature.  All form submissions are automatically time and date stamped.
Parent: I acknowledge that I have received and read a copy of Policy #7315 and the District Guidelines for the Use of District and Personal Technology.   *
Please type your first and last name in the box below. Typing your name in the box constitutes your electronic signature.  All form submissions are automatically time and date stamped.
Students in Grades 9-12 ONLY:  I acknowledge that I have received and read a copy of the Bloomfield School District's Regulation, entitled "Student Use of Email".                                            
Please type your first and last name in the box below. Typing your name in the box constitutes your electronic signature.  All form submissions are automatically time and date stamped.
Parents of students in Grades 9-12 ONLY: I acknowledge that I have received and read a copy of the Bloomfield School District's Regulation, entitled "Student Use of Email".        
Please type your first and last name in the box below. Typing your name in the box constitutes your electronic signature.  All form submissions are automatically time and date stamped.
I do not want my child in grades 9-12 to have a Bloomfield email account.
If you do not want your child to have a Bloomfield email account please check the yes box below.  
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