Family Mobile Device Checkout Form
With schools closed due to COVID-19, Carmel Clay Schools will provide your family with a device if you do not have one in your home.
Please understand your family is responsible for the device. If the device is damaged or lost, your family will be charged for the cost of the repair or replacement.
If you do not have a device for your home, please fill out the following form and the building staff will be in touch.
Student's First Name
Student's Last Name
Student's School ID (if known)
Your Student's School
Cherry Tree Elementary
College Wood Elementary
Forest Dale Elementary
Mohawk Trails Elementary
Orchard Park Elementary
Prairie Trace Elementary
Smoky Row Elementary
Towne Meadow Elementary
West Clay Elementary
Carmel Middle School
Clay Middle School
Creekside Middle School
Carmel High School
Parent/Guardian Email Address
Please provide an email address should we need to get in contact regarding device distribution.
Parent/Guardian Phone Number
Please provide a phone number should we need to get in contact regarding device distribution.
Additional Students and Schools
Please list any other students and the schools they attend at CCS.
By typing my full name below, I agree that if the device is lost, stolen, or damaged I will be responsible for any charges that result. I also understand that the device is being borrowed by my child and must be returned to the school district when requested. *
Please type your full name
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This form was created inside of Carmel Clay Schools.