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2022-23 Chromebook Policy, Insurance, and Social Media Signature Page
This form serves as the signature page and acceptance for the ISD 484 Chromebook Policy, Insurance Options, Social Media and Internet Use Agreement and Discipline Policy. Please review the policy before signing this signature page.
https://mn50010880.schoolwires.net/site/handlers/filedownload.ashx?moduleinstanceid=611&dataid=823&FileName=pierz_isd_484_chromebook_policy_and_agreement_2021_-_2022.pdf
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Last Name of Student
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First Name of Student
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Grade Student is in During the 2021-22 School Year
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5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Chromebook Usage Policy Acceptance
By typing your parent/guardian name, this acts as your signature, accepting and agreeing to the 2021-22 Chromebook Policy and Social Media responsibility awareness and agreement. These documents can be reviewed on the Chromebooks at Healy page under the High School tab or the Chromebooks at Pioneer under the Elementary tab from the district web page.
https://mn50010880.schoolwires.net/site/handlers/filedownload.ashx?moduleinstanceid=611&dataid=823&FileName=pierz_isd_484_chromebook_policy_and_agreement_2021_-_2022.pdf
Typed signature of parent/guardian
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Decline or Accept the Optional Insurance - Choose only one
Choose one option and sign by typing in your name as the parent/guardian
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I AM WAIVING THE OPTIONAL INSURANCE: I have read and agree to the terms and conditions of the 2021-22 1:1 Chromebook Policy, and I will NOT be purchasing the insurance. I understand by waiving the optional insurance fee, I will be solely responsible for any Chromebook repairs as outlined in the Chromebook Policy document. I will also be responsible for full replacement of the device in the case of loss or theft of the Chromebook.
I WILL PURCHASE THE OPTIONAL INSURANCE: I have read and agree to the terms and conditions of the 1:1 Chromebook Policy and WILL be purchasing the non-refundable optional insurance. I understand this insurance will pay for cost of repairs as outlined in the Chromebook Usage Policy. I also understand that negligent use, vandalism, and/or loss of the Chromebook (not including theft) is not covered under the optional insurance fee.
Typed signature of parent/guardian accepting Chromebook Policies
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