Little Rock School District Hand Receipt - Meadowcliff Elem.
Parents,

Please be advised that equipment belonging to the Little Rock School District will be made available for temporary student usage. If you choose to secure one of these devices for your child to use, you will be expected to abide by the guidelines listed below as documented by LRSD policy.

If item(s) is/are lost/stolen/damaged, borrower must immediately report to their responsible Administrator who will complete an incident report. Borrower WILL be held personally liable for the fair market value of item lost/stolen/damaged. NOTE: In the event of theft, loss, or damage to the device when in use off District premises, the asset is NOT covered by LRSD insurance—must be covered by personal homeowners’ or auto insurance.

By completing this document and providing the information listed below, you are agreeing to the terms of usage.
Email *
Please complete one form for each student.
Parent Name *
Parent Drivers License Number *
Parent Contact Number *
Student Name *
Student ID# *
Student Grade *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Little Rock School District. Report Abuse