Device Request - Families 2022-2023

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Device Request - Families 2022-2023

Please fill out this form if you do not have a DOE device and would like to request a device for your child to use at home.

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* Indicates required question

Student First and Last Name *

Your answer

Student Grade and Teacher *

Your answer

Student OSIS (if you know it)

Your answer

Parent/Guardian - First and Last Name *

Your answer

Parent/Guardian- phone number *

Your answer

Parent/Guardian - Email address *

Your answer

Do you have internet at home? *

Yes

No

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This form was created inside of PS 107 Parent Teacher Association. Report Abuse