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RCCSD 1:1 Technology Agreement (SY 20-21)
Please answer all questions below and click submit when complete. One submission is required per student if you have multiple students in grades K-12 in the Red Clay Consolidated School District.
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* Indicates required question
Email
*
Your email
Family Information
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's Lunch ID Number
*
Your answer
Parent/Guardian's First Name
*
Your answer
Parent/Guardian's Last Name
*
Your answer
Parent/Guardian's Email Address
*
Your answer
Parent/Guardian's Phone Number
*
Your answer
Student's 2020-2021 Grade Level
*
Choose
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Student's School
*
Your answer
Technology Usage Agreements
We (Parent/Guardian & Student) have reviewed and agree to Part 1 of the 1:1 Technology Usage Agreement (
https://bit.ly/1to1RCagreements2020
)
*
Yes we have/do.
Required
We (Parent/Guardian & Student) have reviewed and agree to Part 2 of the 1:1 Technology Usage Agreement (
https://bit.ly/1to1RCagreements2020
)
*
Yes we have/do.
Required
Accidental Protection Plan Participation
Based on Information from Part 2 of the 1:1 Technology Usage Agreement, decide how you will participate in the RCCSD Accidental Protection Plan by making a selection below.
Parents/Guardians must choose one of the four options below.
*
I paid the $20 insurance fee on PayPams. Instructions:
https://bit.ly/1to1RCagreements2020
I will send the program fee of $20 to my student's school. Cash or check is accepted. Please make checks payable to Red Clay Consolidated School District.
I understand the RCCSD Chromebook Accidental Protection Plan is for my student’s Chromebook. Please contact me to set up a payment plan option.
I have further questions. Please contact me regarding this fee.
Required
Electronic Signatures
By electronically signing this agreement, Student and Parent/Guardian agree to Part 1 and Part 2 of the 1:1 Technology Usage Agreements, the RCCSD Acceptable Use Policy, and the Student Code of Conduct.
Student Signature: Please type your first and last name in the field below. This serves as your electronic signature.
*
Your answer
Parent/Guardian Signature: Please type your first and last name in the field below. This serves as your electronic signature.
*
Your answer
Parent/Guardian Relationship to Student
*
Mother
Father
Separate Legal Guardian
Other:
A copy of your responses will be emailed to the address you provided.
Submit
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