JDCSD Student and Parent Technology Request

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please indicate if you are a Parent or a Student submitting this form *

Parent

Student

Required

Who would you like us to contact? *

Parent

Student

Required

First and Last Name of person to contact *

Preferred contact method: Email or Phone? Please provide information below. *

Phone

Required

Based on your answer above please provide Email/Phone number below.

Grade level *

Please explain the problem that you are experiencing including any error messages. *

Have you rebooted your computer? *

Yes

Not Applicable

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Jamesville DeWitt Central School District. Report Abuse