Chromebook Check-out Form for Students
During an extended school closure, Mahtomedi Public Schools will be continuing to provide education to students through distance learning. Students engaging in distance learning have access to appropriate educational materials and receive daily interaction with their licensed teacher.

Please consider the current situation in your home and decide if you have adequate access to technology that will allow your child to connect to the internet to access their daily work. If you anticipate you will need to check out a Chromebook from the school district during this extended school closure, please complete this form.

A representative of the school district will contact you when the Chromebook is ready for pick up.

Student First Name *
Your answer
Student Last Name *
Your answer
Student ID Number *
Student ID numbers can be located in ParentVUE (https://pvue6.region1.k12.mn.us/rt0832) on the Student Info page. It is listed under the heading Perm ID. If you need assistance with ParentVUE, please visit https://www.mahtomedi.k12.mn.us/page/3297.
Your answer
Student's Current School *
Student's Current Grade
Please list the name and grade of other children in your home who will also be using this device.
Your answer
I may also need assistance or support accessing the Internet or wifi in my home. Please have a representative of the school district contact me via email or phone to discuss options.
Name of Parent/Guardian Completing this Form *
Your answer
Parent/Guardian Cell Number *
Your answer
Parent/Guardian Email Address *
Your answer
Parent/Guardian Acknowledgements
Acceptable Use Verification *
Parents/Guardians must verify that they have read District Policy #524 (http://bit.ly/Policy524_rev05232019) relating to safety and acceptable use of the school district computer system and the Internet.
Required
I understand and agree to the following conditions for borrowing a Chromebook device: *
Required
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