BHS Chromebook Request Form
Brookline High School is committed to making sure that all students have access to a device to support learning. If you need to borrow a Chromebook for any reason, please complete this form.

If you have more than a single need, please complete this form for each student.

Chromebooks will not be available until school starts in September. You will be emailed when the chromebook is ready for pickup at the 115 Library.

Sign in to Google to save your progress. Learn more
Email *
Student First Name: *
Student Last Name: *
Year of Graduation *
Student's School-issued Account Email Address (e.g. 27smithp@brooklinek12.org) *
Programs (if Known)
Brookline High school has many programs that support students. If you are a member of any of these programs, please let us know so we can inform program leaders. Check all that apply.
Do you have a reliable Internet connection at home? *
Additional Comments, Questions, Concerns:
Parent/Guardian Name: *
Parent/Guardian Email: *
Student Technology Loan Agreement
  • Please download this document. Chromebook Loan Agreement
  • Student and parents/guardians sign. 
  • You will need a signed agreement form to pick up your device.
  • Copies will be available in the library if you do not have printer access.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Public Schools of Brookline. Report Abuse
Google Forms