Chromebook Checkout Request
Home technology needs questionnaire
Student First Name *
Your answer
Student Last Name *
Your answer
Student ID Number *
Your answer
Grade Level *
Please choose the option that best describes your access to an internet connected device (tablet, computer, etc.) at home *
If you selected "I have my own personal device(s)" for the last item, please indicate the type of device(s) below. Select all that apply *
Do you have reliable fast internet access at home (reliable enough that you don’t have to think about whether it will work when you need it to work)? *
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