Remote Learning Device Request
Please complete the following form to request a Chromebook to use while we are doing remote learning.
Student LAST Name
Student FIRST name
We currently have reliable internet access
Internet access is available, but we have not purchased it.
Reliable and/or sufficient Internet access is not available at our home.
I would like for the school to provide a device for my student to use for remote learning.
My student has a device I would prefer they use for remote learning (Cell phones do not work)
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Schools.