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SY2020-21 VCHS School Learning Device Request
SLD Form for SY2020-21 (MUST enter Parent/Guardian email below)
* Indicates required question
Email
*
Your email
Guardian First Name
*
Your answer
Guardian Last Name
*
Your answer
Guardian Phone #
*
Your answer
Guardian's Relationship with Student
*
Your answer
STUDENT FIRST NAME
*
Your answer
STUDENT LAST NAME
*
Your answer
STUDENT ID #
*
Your answer
STUDENT DOE EMAIL
*
Your answer
Student Grade Level
*
9
10
11
12
Does the student have Computer access?
*
Yes
No
Does the student have Internet access?
*
Yes
No
Does the student live in a shelter?
*
Yes
No
Does the student’s family live with another family or other person because of loss of housing or as a result of economic hardship?
*
Yes
No
Is the student currently in foster care?
*
Yes
No
Does the student live in NYCHA housing?
*
Yes
No
Does the student have SmartPhone access?
*
Yes
No
!!!DEVICE AGREEMENT!!! MUST READ
PLEASE COPY AND PASTE THIS URL TO YOUR BROWSER TO READ THE DEVICE AGREEMENT:
https://coronavirus.schools.nyc/devicerequest/deviceagreement
Send me a copy of my responses.
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