Checkout and Agreement Form for Chromebooks and Laptops

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*Please note-A deposit is required when checking out a laptop or Chromebook. The details can be found at the end of this form.

Email *

Last Name- Họ- Apellido *

First Name- Tên thánh - Nombre *

Student ID#-

Số thẻ sinh viên

Número de identificación del estudiante

Birthdate- Ngày sinh - Nacimiento *

YYYY

Phone Number- Số điện thoại - Número de teléfono *

Instructor - Giáo viên - Maestro *

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