Device Repair Portal - 21/22 School Year
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First and Last Name of User
First and Last Name of Person Submitting This Request
Relationship to User
Day Time Phone Number or Email Address
Pick-up location (Classroom # or Street Address if e-learning)
Type of Device
Device ID Number
This number is written on the back of your device.
Problem with the device
Power: Battery won't charge, loses charge quickly, won't power on
Physical damage: cracked screen, damaged power port, keys missing
Device is frozen or unresponsive
Password or app problems
Teacher/Admin ONLY - Service of teacher/admin device
Teacher/Admin ONLY - Request a device for a new student
Teacher/Admin ONLY - Pick up device that is no longer needed (return to replacement pool)
Cause of the damage?
Intentional damage caused by student or family member
Accidental damage caused by student or family member, as a result of temper tantrum or negligence
Regular wear and tear
Damage caused by staff member or other student while at school
Request is not related to damage
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