SFUSD Distance Learning Device Request
Thank you for completing this survey. The information gathered here will help SFUSD plan for student device needs due to school closures. SFUSD will lend a district Chromebook to students in grades 3-12 to support distance learning. If your student needs a device, please fill out the form below.

SFUSD will communicate with you using the phone number and email provided to share how to receive a device. Priority will be given to students most in need, and all devices are granted on a temporary basis and will later need to be returned. There is a limit of one device per student.
Email address *
Parent/Guardian First Name: *
Parent/Guardian Last Name: *
Guardian Phone Number: *
Please enter your number in this format: ###-###-####
Student First Name: *
Student Last Name: *
Student ID Number, if known.
School Name: *
Grade Level *
Does your student have Internet access at home? *
Internet access to connect a Chromebook
Does your student have access to a computer, laptop, or tablet at home that can be connected to the Internet every day for school work? *
Next
Never submit passwords through Google Forms.
This form was created inside of San Francisco Unified School District.