2020 Elementary iPad Evaluation
Please inspect your iPad and note any dent/crack/concerns on this form.

****The cost for items not returned is listed below:
Blue case - $10.00
Charging Block - $19.00
Cable - $19.00
Cracked Screen - $10.00
Student FIRST Name *
Student LAST Name *
Asset Tag *
Is the SCREEN CRACKED? ($10.00) *
Did the student return the CHARGING BLOCK? ($19.00) *
Did the student return the CHARGING CABLE? ($19.00) *
Did the student return the BLUE CASE? ($10.00) *
Do you have any other items of concern for your iPad? *
Parent's Name *
Parent's Phone *
KEENE ISD Employee fill out this form *
****WIPE DEVICE (Settings/General/Reset/Erase all Content and Settings)
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