JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
DSHS Chromebook Repair Form
Please fill out the following form and the library staff will either deliver a loaner to your classroom or call you down to the library to drop off your broken chromebook and pick up a loaner.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Student I.D. Number
*
Your answer
Chromebook Model
*
Acer
Lenevo
Other:
Grade
*
9th
10th
11th
12th
Type in Asset Tag Number below(5-6 digit number on the back of the chromebook)
*
Your answer
Reason for Service
*
Cracked Screen
Broken Hinge
Keyboard not working (list specific keys under Other)
Headphone Jack not working
Lost Device: Last Known Location
Battery Issue
Disk Full
Wifi Connectivity Issue
Failed Critical Update
Power button stuck
Other
Any other important details
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dublin City Schools.
Report Abuse
Forms
