AHES Student Device Application
In an effort to support the Guam Department of Education’s Distance Learning goals, public school students will be provided with a grade-appropriate electronic device. This will ensure that teaching and learning continue to take place despite any short- or long-term interruptions. Parents/Guardians may check out the electronic devices at their child’s school. Families with multiple students at different schools must apply/obtain a device from each of their children's respective school. Devices must be picked up and signed out by a parent/guardian and student unless student is 18 years old or older. Adult students may pick up devices on their own.

By completing this application, parent/guardian/student agree that the device is strictly for educational purposes. Students must attend online classes regularly, actively participate in virtual learning classes, and complete and submit assignments in a timely manner.

Sign in to Google to save your progress. Learn more
Last Name *
First Name and Middle Initial *
Student ID Number *
Grade Level *
Room Number *
Student Date of Birth *
MM
/
DD
/
YYYY
Student GDOE Email Address *
Parent/Guardian Last Name *
Parent/Guardian First Name and Middle Initial *
Full Physical Address *
Mailing Address *
Home Phone Number
Work Number
Mobile Number
Parent/Guardian Email Address *
Internet Access
Yes
No
Access to Reliable Internet
Power Source (Electricity)
NO Access to Internet
If a student does not have internet access and if given a device, will the student be able to access internet elsewhere for the purpose of distance learning?
Number of Devices
1
2
3
More than 3
Laptop / Desktop Computer
Tablet / iPad
Mobile Phone
Shared Devices *
Yes
No
If you have more than one (1) student in your household, do they share devices they have access to listed above?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Guam Department of Education. Report Abuse
Google Forms