Exploration Student Chromebook Request Form and Agreement
Goal: Expand Distance Learning Opportunities for students who need technology at home

Harmony Public Schools is committed to helping students and their teachers continue learning outside of school. Students with no technology device available for at-home learning may receive a Chromebook for their use at home. The limit for checkout is one device per actively enrolled student at Harmony School of Exploration.

Please submit your request as soon as possible, so you and your child can become familiar with this device before the start of instruction on Monday, August 17.
Email address *
Chromebook Distribution
August 12th from 1:00pm -4:00 pm for the last names of A-K
August 13th from 1:00pm -4:00 pm for the last names of L-Z

The student must be present at the time of issuing the device, and student ID numbers will be verified in advance of pick-up to ensure the student is currently enrolled in HPS.
Student's FIRST name ? *
Student's LAST name ? *
Student's date of birth? *
MM
/
DD
/
YYYY
Skyward Student Number ? *
Student's GRADE LEVEL ? *
What is the home address of the enrolled student? *
Do you have internet access at home?
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