Student/Parent Technology Request form

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Student/Parent Technology Request form

Before completing this form, please consult our Technology Resource Guide for support:
https://sites.google.com/csh.k12.ny.us/studenttech/home

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* Indicates required question

Email *

Your email

Parent Name (Last, First) *

Your answer

Best Contact Email address *

Your answer

Best Contact Phone Number (Not Required)

Your answer

Student Name (Last, First) *

Your answer

Building *

Goosehill Primary

Lloyd Harbor

West Side

Jr./Sr HS

Student Grade Level *

Choose

K

1

2

3

4

5

6

7

8

9

10

11

12

Please provide a detailed description of the difficulty you are experiencing *

Your answer

Submit

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