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MPS Optional Annual Insurance 2023-2024 (Grades 10-12)
It is
highly recommended
that families participate in an optional annual insurance program to provide coverage in case of loss or damage to the district-provided Chromebook. If you are not enrolled in this program, all costs associated with loss or damage to the device will be parents’/guardians’ responsibility. There is a $30 annual fee for the optional insurance program.
Please fill out this form for each student attending Maynard Public Schools in grades 10-12 whether or not choosing to sign up for insurance. No form or insurance is needed for students from pre-kindergarten through 4th grade. A separate form will be going out to families of students in grades 5-9.
Click here for more detail on the optional insurance program.
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Student First Name:
*
Your answer
Student Last Name:
*
Your answer
Student Grade for 2023-2024 School Year:
*
Choose
10
11
12
Other
Most students going into grades 10-12 have an MPS Chromebook at home. Please provide the a
sset tag (barcode #) from the bottom of the Chromebook. Chromebooks not registered here will be locked before the start of school.
*
Your answer
Optional Insurance
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I choose to enroll in the optional device insurance program for $30 (details on payment below)
I choose to waive participation in the optional insurance program
Parent Name indicating agreement to enroll or waive participation in the optional insurance program:
*
Your answer
Parent E-mail Address:
*
Your answer
Check this box to indicate financial hardship:
Financial hardship
If choosing to participate in the insurance program,
pay using MySchoolBucks by clicking this link
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