Chromebook Incident Report: Please complete all sections in detail in order to process the Accidental Insurance. If there is not enough detail chromebooks will not be repaired.

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Please complete this form with as much information as possible. If you are experiencing issues with your device not powering on or charging, please follow the troubleshoot directions at this link: bit.ly/SMMDLP

Email *

When did you notice the issue? *

YYYY

School Site *

Grade level *

Last name *

First name *

Student ID# *

Phone number for us to reach you to troubleshoot *

What is the problem with your Chromebook? *

charger

keys

screen

trackpad

will not charge (BEFORE YOU SUBMIT THIS FORM, please visit the troubleshooting website here: bit.ly/SMMDLP)

will not connect to the internet

will not power on (BEFORE YOU SUBMIT THIS FORM, please visit the troubleshooting website here: bit.ly/SMMDLP)

black screen

lost

stolen

Other:

Please explain in a couple sentences what happened to your Chromebook. For example - If the screen broke, how did it happen? *

Chromebook Asset Tag #: *

The asset tag is located underneath your Chromebook.

Was this an accident? *

Yes

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