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EASTERN Device Request Form
For 10th - 12th Grade Students AND Returning Freshman Level Students (DO NOT USE FOR REQUESTING LOANER EQUIPMENT - IF YOU LEFT YOUR DEVICE AT HOME, ETC., YOU MUST BORROW TECH FROM YOUR TEACHER)
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* Indicates required question
Email
*
Your email
Student LAST NAME
*
Your answer
Student FIRST NAME
*
Your answer
GRADE
*
9
10
11
12
Unsure
Current Tech Status
*
Have PERSONAL Laptop
Have EASTERN Tablet
Have PERSONAL Cell Phone ONLY
DON'T HAVE ANY TECH ACCESS
English Teacher's LAST NAME (Please check student portal for accurate spelling)
*
Your answer
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