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Student Technology Request
Please fill out this form if your student is in need of a Chromebook and/or having internet access difficulty. (Please submit separate forms for each of your students)
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* Indicates required question
Student Name
*
First and Last Name
Your answer
Student ID Number
*
Your answer
Parent/Guardian Name
*
First and Last Name
Your answer
Parent/Guardian Phone Number
*
Your answer
Parent/Guardian Email Address
Your answer
School Site
*
Choose
Bay
Colonial Acres
Corvallis
Dayton
Del Rey
Grant
Hesperian
Hillside
Lorenzo Manor
Bohannon
Edendale
Washington Manor
Arroyo
East Bay Arts
Royal Sunset
San Lorenzo
DICE - Lewelling
Technology Request
*
Request for a Chromebook (New or Replacement)
Experiencing difficulty with Internet Access (Low Bandwidth or No Connection)
Required
Preferred Contact Method
*
Phone
Email
Required
Submit
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