Remote Learning Technology Support

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PLEASE NOTE: FILLING OUT THIS FORM DOES NOT GUARANTEE THAT WE WILL BE ABLE TO ISSUE A CHROMEBOOK TO YOUR CHILD.

Student First Name *

Student Lame Name *

Current Grade Level: *

Student Homeroom Number/Teacher *

Student Priority Group *

Student In Temporary Living Situations

English Language Learners

Students with Diverse Learning Needs

International Baccalaureate

Montessori

Parent First Name: *

Parent Last Name: *

Parent E-mail Address *

Parent Telephone Number: *

Parents we will email you back regarding device availability. We have a limited number of computers to distribute and priority will go to the highest need students per the CPS guidelines. Please be aware that the device agreement includes responsibility of replacement and repair should the device be damaged while on loan to the student. Cost of replacement for a Chromebook is $250. * *

Yes, I understand and agree to these guidlines.

No, I do not agree to these guidlines.

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