Technology request for Remote Learning Program

GEMS American Academy is committed to provide students with a quality education relevant to their grade and curriculum. As we are promoting remote learning program we do not want our students to be left behind due to unavailability of technology at home. Hence, we provide an opportunity to our learners to borrow a device from school and reach their learning goals.

Please submit a separate form for each student.

Email address *

I am a *

Father

Mother

Guardian

Student

GAA Teacher or Staff

My name is *

Student name *

Student Grade *

Student School ID *

I would like to request for *

an iPad

an iPad with power adapter

a MacBook Air

a MacBook Air with power adapter

Consent *

"Should the device be lost or damaged through negligence on my part, I assume full responsibility for such device and I shall make payment to the school at the price shown on the Equipment Inventory Record. I understand the school may require the return of the device at any time."

Required

A copy of your responses will be emailed to the address you provided.

Submit

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of GEMS American Academy. Report Abuse

Forms