Chromebook Distribution Signup Form - Grades 10-12 Only
1. Provide your name and the student name(s) for which you will be picking up chromebooks.

2. Select a distribution date and time that works with your schedule. (Distribution is limited to approximately 100 students per session and dates will be removed as seats fill up.)

NOTE: Freshmen Chromebooks will be distributed on Aug 14th at the Freshmen Orientation.

Email address
Parent/Guardian Name
Your answer
Email address for confirmation
Your answer
Student Name 1
Your answer
Student Name 2
Your answer
Student Name 3
Your answer
Which distribution event will you attend?
Are you interested in purchasing optional $25 Chromebook insurance?
This fee will be added to registration fees. Chromebook insurance details will be included in the paperwork and presentation at the distribution event. In simple terms this $25/year optional insurance will provide financial protection to the family in the event of accidental damage caused by the student. If no insurance is purchased the full cost of repair will be the responsibility of the family. Checking yes or no below does not lock you in to a decision, but gives us the ability to add this to your registration fees in advance. The deadline for purchasing insurance will be the first day of school.
Do you have questions about our 1:1 Chromebook Program?
Please take this opportunity to voice concerns or ask questions about our program. We will produce a FAQ document ( from these questions and try to address them at our distribution meetings. Thank you for your input!
Your answer
Please complete the captcha before submitting the form.
Never submit passwords through Google Forms.
This form was created inside of Mendota High School. Report Abuse - Terms of Service - Additional Terms