Chromebook Checkout Request
Home technology needs questionnaire
Student First Name
Student Last Name
Student ID Number
Please choose the option that best describes your access to an internet connected device (tablet, computer, etc.) at home
I do not have access to a tablet, Chromebook, laptop, or computer at home
The device I use to access the internet is outdated and slow
I share a device or devices with other family members
I have my own personal device(s).
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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This form was created inside of Antelope Valley Union High School District.