Central Christian Academy Continuous Learning - Mobile Device Request Form
Please fill out this form to request a device if you are in a true need. We have a limited quantity, so keep in mind if you have one device per 2 children that should be sufficient for CCA's continuous learning plan.  If you have multiple students who will need a device, please fill out the form for each student.  

By submitting this form, you acknowledge and understand that it is your responsibility to pick up the device and all of the accessories. At the end of the borrowing period determined by Central Christian Academy you must return it to the same location.

You also understand that Central Christian Academy may only provide limited assistance, and it is your responsibility to maintain and keep this device in good working order.  

If our stock of devices runs low, we will do our best to find a device to those in great need. We may have a solution for you. Please contact the main office for questions as well, (316) 688-1161.  God is an amazing provider and has blessed us in so many ways. 🙏✝
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Email *
Please make an appointment with the office for pickup of your device (316)688-1161.  Curbside pickup can be available if you specify with the office.  Please call with multiple pickup time options so we can best meet your need. NEW OFFICE HOURS: 8:00 am - 12:00 pm
Parent/Guardian Email Address *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Student First Name *
Student Last Name *
Student's Grade *
Homeroom Teacher (put none if this doesn't apply) *
Additional Comments or Questions
😁You will be required to sign this form below when you pick up your device.  Please read it over now so you can sign the copy we give you quickly when you come on campus to receive your device.
Technology checkout form to sign when on school campus - pg 1
Technology checkout form to sign when on school campus - pg 2
A copy of your responses will be emailed to the address you provided.
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