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MPS Optional Insurance 2022-2023 (Grades 5-9)
It is
highly recommended
that families participate in an optional insurance program to provide coverage in case of loss or damage to the device. If you are not enrolled in this program, all costs associated with loss or damage to the device will be parents’/guardians’ responsibility.
Please fill out this form for each student attending Maynard Public Schools in grades 5-9. No insurance is needed for students from pre-kindergarten through 4th grade. There is a separate form for grades 10-12 linked in the form below.
Click here for more detail on the optional insurance program.
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Student First Name:
Your answer
Student Last Name:
Your answer
Student School:
Fowler School
Maynard High School
Out of District
Other:
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Student Grade for 2022-2023 School Year:
Choose
5
6
7
8
9
Optional Insurance
*
I choose to enroll in the optional device insurance program for $30 (details on payment below)
I choose to waive participation in the optional insurance program
Parent Name indicating agreement to enroll or waive participation in the optional insurance program:
Your answer
Parent E-mail Address:
Your answer
Check this box to indicate financial hardship:
Finance hardship
Pay Online with MySchoolBucks
To pay for your Optional Chromebook Insurance,
click here to go to MySchoolBucks
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