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 *
Cause of the damage? *
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