Technology Access Request Form

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Use this form to request technology access from the North College Hill City Schools Tech Department

First Name: *

Last Name: *

Position/Organization: *

Department:

If a Student teacher please enter the classroom teacher's name for which you are assigned to be with:

Building/Location *

BOE

Trojan Way Learning Center

Elementary School

Midde School

High School

District (Roaming)

Request For: *

Network Access (Wifi Pw)

iPad

Laptop

Chromebook

Email Account

Required

If Requesting an Email Account, Please Provide an Alternate Email for Communication:

By signing your name, you acknowledge that you have agreed to the terms of the accompanying NCHSD Internet Acceptable Use Policy
and the NCHSD Student and Staff Personal Device Policy.

Misuse of the North College Hill City School District’s network, email, or Internet systems - on school-owned technology as well as on personal electronic devices brought onto school property - in violation of this or any other Board policy or in violation of the law, may result in the revocation of access to the district’s network, email, and Internet systems, along with appropriate disciplinary action, up to and including termination from employment and possible criminal prosecution.

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