PURPOSE: Monroe County Schools and its programs allow students the option of bringing in a
personal electronic device (also considered a device capable of making cellular calls and accessing
internet data, netbook, ipod touch, macbook, or iPad) as a means to enhance their education. The
purpose of these guidelines is to assure students recognize limitations the school imposes on their
use of these devices. In addition to these guidelines, the use of any computer in school, including
laptop computers, requiresstudents to abide by the District Acceptable Use Policy. A signed District
Acceptable Use Policy must be on file for the student to qualify to bring a personal electronic device
to school.

During the course of the school year, additional rules regarding the use of personal electronic
devices may be added. If this occurs, any new rule will become a part of this policy.

Agreement –
• To comply with the rules and regulations in the guidelines.
• That any staff member may examine the device at any time for the purpose of verifying that my personal
device is in compliance with this agreement.
• That the Monroe School District is not responsible for any possible damage in connection to using a
device in Monroe County Schools
• To hold the Monroe County School District harmless in the event of theft, damage, loss, or confiscation
of a student’s device.
• That the district technicians will not troubleshoot or install software on personal devices.
• It is understood that connection to third party access point or the establishment of ad‐hoc network
access via home or other internet devices is not permitted.
• That using my device at school is a privilege and can be revoked at any time.
• Understand this agreement can be modified at any time and a new agreement would need to be signed.

Students and their parents/guardians wishing to take advantage of this program must comply with all rules and
regulations set forth in these Guidelines and the applicable Board Policy and Regulation. By choosing to
participate in this program, the parties – the parent/guardian and the student -- are consenting to monitoring
and verification of use, and to examination of the student’s device as set forth above.
Sign in to Google to save your progress. Learn more
Student Name *
Grade *
School *
Device Description *
Serial Number of Device *
Brief Description of device. *
Phone Number *
Parent/Guardian Name *
Parent/Guardian Personal Email *
As a parent or guardian, I have read the Monroe County Schools Acceptable Use Policy and understand that this access is designed for educational purposes ONLY. I understand that BYOT (Bring Your Own Technology) is a privilege and not a right. *
Any misuse of technology will result in BYOT privilege revocation along with any applicable disciplinary measures.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Monroe County Schools. Report Abuse