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RHS Damaged Chromebook Form
For students to fill out when they have a damaged Chromebook
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* Indicates required question
Email
*
Your email
School
*
Choose
Reidsville High School
Date of Incident
*
MM
/
DD
/
YYYY
Today's Date
*
MM
/
DD
/
YYYY
Students First Name
*
Your answer
Students Last Name
*
Your answer
Contact Phone Number
*
Your answer
Grade
*
Freshman
Sophomore
Junior
Senior
Student ID
*
Your answer
Has the Chromebook Insurance for the 2021-2022 school year been paid?
*
Yes
No
Serial Number of Chromebook (Located on bottom of device)
*
Your answer
What is wrong and exactly how did it happen?
*
Your answer
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