Device Request Form
Required
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Student's Name (First and Last) *
Student Grade *
Is your child in the Migrant Education Program? *
Request Type *Please select the appropriate request type. *
Device(s) to be returned to ASD *If scheduling a device return, remind the student/parent to also return all power cords and adapters for the device. PLEASE NOTE: "pick-up" means that we are collecting a device that is broken or no longer needed. ASD WILL SCHEDULE A PICK UP OF THE DEVICES TO BE RETURNED. Therefore, an accurate address is needed. *
Required
Device(s) Delivered by ASD *Reminder: This form does NOT address the delivery of internet connectivity devices. *
Required
Street Address for Delivery or Pick Up *
City for Delivery or Pick Up *
Required
Contact Phone Number *
Notes/Delivery or Pick Up Requests (Optional)
Policy Acknowledgement: I (parent/guardian) hereby certify the information provided is accurate. Additionally I understand that the device remains the property of the Anchorage School District. I agree to abide by the school district's policies regarding the care and proper use of the district devices. *
Required
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