2020-2021 Madison High School Device Request Form
Please complete the following form if you are in need of a school issued device for virtual learning. Please complete one form per student enrolled at Madison High School for which a device is requested.
By submitting a request you are agreeing to the following terms of use:
-Take responsibility for technology provided and use the equipment for educational purposes only.
-Maintain the equipment in working condition while said equipment is in your possession.
-Return the equipment in the same working condition that you received it to designated personnel.
-Agree to and understand that if the technology equipment, software, and other related items are stolen, vandalized, misplaced, destroyed, etc. that you are responsible and will reimburse (pay) the District the amount required to replace or repair the equipment.
There is no charge to borrow a school device, but there could be fees charged for damaged or lost items as follows:
Responsible party will be required to pay:
$25 replacement fee for lost/not returned or damaged power adapter
$50 repair fee for missing keys
$100 repair fee for cracked/broken screen/keyboard
Up to $250 replacement fee for destroyed, lost, or not returned device