DCS Student Device Check-out Request
This form is for the check-out of a single Chromebook and charger per household to facilitate distance learning.

By requesting a District-issued Chromebook, you agree to use the device only for school business, and in accordance with the DCS Acceptable Use Policy for Technology. Additionally, you acknowledge that you are responsible for the device and any accessories issued to your household. You agree to return all District equipment in good working order when requested by the District, or be held liable for repair or replacement as deemed necessary by the District.
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If there are multiple DCS students in your household, please only fill out this information for one of them.
Student Last Name *
Student First Name
Student ID (Found in ParentVUE: https://parentvue.geneseeisd.org/davs/ or enter 000000 if unknown.) *
Parent/Guardian Last Name
Parent/Guardian First Name *
Parent/Guardian Contact Phone *
Parent/Guardian Contact Email *
Which building does your student attend? *
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