BSD CHROMEBOOK DAMAGE/LOSS REPORT
Student's Last Name *
Student's First Name *
Asset Tag # *On the back of Chromebook (white label) *
School Building *
Grade *
Date *
MM
/
DD
/
YYYY
Description of Damage/Loss/Theft (include how damage occurred): *
Student Name and Initials *denotes electronic signature
Parent/Guardian Name and Initials *denotes electronic signature
Parent/Guardian Phone Number
Parent/Guardian Email
Principal Name *Enter if completing on behalf of the family
Parent Notified *If completed by principal or student
Clear selection
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