Technology Request form
Welcome to the 2025/2026 school year at Learners and Leaders. Please fill out the survey below regarding NYC Public School remote learning devices. All families requesting a DOE issued iPad must fill out a loan agreement. Once you fill out the survey below requesting a device, you will receive an email to come to the school to fill out the loan agreement and pick up the device. Please note that the DOE issued iPads are for use at home should our school need to move to remote learning and do not need to be brought to school. Students will have access to chrome books for use while in the school building.  Please note, as devices are limited please request only if you are in need.  
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Parent Name
Nombre del padre
 *
Parent Email
Correo electrónico de padre
 *
Best Contact Number
Mejor número de contacto
 *
Student Name 
Nombre de estudiante
 *
Last Name 
Apellido
 *
Class
Salon 
 *
Do you need a device?
Necesita tecnologia?
 *
Submit
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