Request to Check Out A Chromebook From MPMS  (6th & 7th Grades)
If you are going to be absent from school for an extended period of time and need to check out your Chromebook and a loaner charger, please fill out this form at least 2 school days in advance of your absence. (In case of a sudden sickness or emergency we will waive the 2 days in advance and try to accommodate student and parents.) Your Chromebook will be checked out from your homeroom teacher. Chargers will be checked out from the office and returned to the office.
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Student's Last Name (as in PowerSchool) *
Student's  First Name (as in Power School) *
Homeroom Teacher *
What is the number of your Chromebook? (Letter and Number on Card in pocket on outside of case; Example: A25) *
Reason for checking out your Chromebook and charger *
What is the date for checkout? *
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When do you expect to return the Chromebook and charger to school? *
MM
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DD
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YYYY
Student Agreement: I understand that it is my responsibility to take good care of the Chromebook and charger while I have it and  will be responsible for any damages that occur while it is in my possession.

Student Signature (Type your first and last name):
 *
Parent Agreement: I understand that my child will be responsible for taking good care of the Chromebook and charger and will return it to school on his/her first day back.

Parent Signature (Type First and Last Name):
 *
Phone Number Where Parent Can Be Reached *
Email Where Parent Can Be Reached *
Who Will Pick Up the Chromebook? (Will student be at school to take it home or will parent come to school to pick it up?) *
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