Student Laptop Request Form
Student learning devices are loaned to students who are learning from home for extended periods of time. Please complete this form providing details of the student who is borrowing the device. Parents/Carers will need to complete the form prior to receiving a device.
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Child 1 Full Name *
Please include your child's first and last name:
Child 1 Class *
Please indicate which class your child is in:
Child 2 Full Name
Please include your child's first and last name:
Child 2
Please indicate which class your child is in:
Child 3 Full Name
Please include your child's first and last name:
Child 3
Please indicate which class your child is in:
Child 4 Full Name
Please include your child's first and last name:
Child 4
Please indicate which class your child is in:
Loan Agreement:
Parent/Carer Full Name *
Contact Number *
Full address where the device will be housed *
By ticking the box below, I agree to the terms and conditions of loaning a student learning device from Glendenning Public School. *
Required
Date *
MM
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DD
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YYYY
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