Deubrook Computer Check-Out 2019-2020 Form
All students are responsible for any damage that occurs to their school computer. If the computer is damaged you will be charged a $25 or $50 fee depending on the amount of damage. *
First Name *
Your answer
Last Name *
Your answer
Tablet Model *
Tablet Number *
Your answer
Serial Number *
Your answer
Grade *
Computer Screen - Does the touch screen work? *
Does your computer have a stylus *
Stylus - Does it work? *
Tether for Stylus *
Keyboard - Does it work properly? *
Power Adapter with Cord, Number should match your computer number. *
Computer Case/Sleeve *
Name Tag Attached to the Computer Case/Sleeve *
Comments Area
Comments - Please indicate any damage or issues with the computer? This is very important to record all information, as this is what the Deubrook Technology Staff will look at, if you have damage to your computer at the end of the school year. Reminder if you damage your computer, you will be charged a fee of $25 or $50 depending on the amount of the damage. *
Your answer
To receive your computer you must record your full name below. *
Your answer
Submit
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