Wrentham Public Schools Device Request Form
Please complete the following form to request a Chromebook for your child during hybrid or remote learning. We will contact you regarding pickup arrangements via email.

Only complete this form if you are requesting a device. If you are requesting to borrow a device for more than one child, please complete a form for each child.
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Student First Name *
Student Last Name *
What grade will your student be entering in September 2020? *
Parent First Name *
Parent Last Name *
Parent Email Address *
License Plate Number of the car that will be used to pickup the device *
Do you have internet access at home? *
Chromebook Lending Agreement for Students and their Families
The Chromebook you are borrowing, purchased by the Wrentham Public Schools, is to be temporarily assigned to the student named above to assist in the student’s education. Use of the property is contingent upon compliance with this Agreement, the Parent/Student Technology Use Policy and Agreement, the Parent and Student Handbook (https://bit.ly/2yeA2Uj), and the student’s active enrollment in the Wrentham Public Schools.

While the property is off school grounds, the adult named above is fully responsible for any loss or damage as well as the content the student can access. The adult named above is expected to reimburse the school for the fair market value or cost of any repair. Loss or theft of the property must be reported to the Wrentham Public Schools within 24 hours of the occurrence.

If any of the property below should cease to function or suffer an unrecoverable error, a description of the events immediately prior to the malfunction and all of the property below must be turned over to the Wrentham Public Schools within 48 hours. After a brief assessment, the Director of Technology will either return the property for the remainder of the lending period, present a new Agreement with a replacement, or reassess the student’s eligibility.

The Chromebook must be returned to school by June, 30th 2021 unless an extension is given.

Please direct any questions about this agreement to Director of Technology, Sean Ahern, aherns@wrenthamschools.org
Student Signature *
Student, please type your name to serve as your electronic signature and indicate that you understand your responsibilities outlined in the Chromebook Lending Agreement listed above.
Parent Signature *
Parent, please type your name to serve as your electronic signature and indicate that you agree to the terms of the Chromebook Lending Agreement listed above.
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