AMSA Computer Request Form 2020-21
This form should only be filled out if your student does not currently have a computer or chromebook to use at home for remote learning. Please fill in this form in order to request a device from AMSA for the 2020-21 school year. If you have more than one AMSA student in need of a computer, please fill out a separate form for each child. You may contact Erica Piotrowski, AMSA's IT Director, with any questions at e.piotrowski@amsacs.org.
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Student's Name *
Student's Grade *
Do you have internet access in your home? *
AMSA expects the student to adhere to the current Student/Parent Handbook policies pertaining to electronic/internet/computer use. The parent's typed name below will serve as confirmation that you agree to follow the Handbook and also that you will be responsible for the cost of any damage to or loss of the computer and/or accessories.
Please enter your (the parent's) name as your digital signature. *
Parent's email address *
Parent's preferred phone number *
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