District 146 E-Learning Technical Assistance Request Form
After submitting this form, someone from our District 146 Technology Department will contact you at the e-mail address provided. Please submit a form for each individual student technical issue. Thank you for your continued patience. We look forward to working with you.
Email *
Name of the individual requesting assistance: *
An e-mail address to respond to your request: *
A contact number to reach you at: *
Student's name: *
Student's School: *
Student's Teacher:
Student's Grade Level: *
Briefly describe your technical issue: *
Never submit passwords through Google Forms.
This form was created inside of Community Consolidated School District 146. Report Abuse