2022-23 Grade 7-12 Technology / Media Signature Page
Please read/review the Acceptable Use Policy and Device Agreement (links below) with your student, then complete the form below as your electronic signature.  Complete one form for each student. Grades 7-12 are responsible for a $35 yearly technology fee, which may be paid at time of pickup, mailed to the office, or paid online via the K-12 payment center (www. k12paymentcenter.com ). You may need to set up an account.  Please login to see your fee balance. Forms and payment must be received in order to pickup laptop.
If you have questions, please contact Lu Larsen at 218-945-6953 or tech@isd599.org

Link for Grades 7-12 Agreement - -
http://www.fertilebeltrami.k12.mn.us/Website/pages/Tech%20Forms/22-23UC.pdf

Link for District Policy Handbook Item # 524 - Internet Acceptable Use Policy
http://www.fertilebeltrami.k12.mn.us/Website/pages/Tech%20Forms/Article524.pdf

* * * New for year 2022-23 School year * * *
Included on this form is the Acceptance for Media Release for your student.  Please read the Media Release Acceptance statement here - -
https://docs.google.com/document/d/1fRpTUFV_KDV2Mhq_OPW_BCmbzU4rzgtEL84mviDjqek/edit?usp=sharing
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Student Name *
Student Grade *
Student Address and Phone # *
Parent Name *
Parent address and Phone # *
Check the following..  By signing, I understand that: *
Required
Student Signature *
Required
Parent Signature *
Required
Media Release Acceptance..  Please indicate your choice: *
Date *
MM
/
DD
/
YYYY
Device Number and Model (School will complete this section)
Serial Number (School will complete this section)
Submit
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