Request for day loan of a school Chromebook

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Students are expected to bring their fully charged devices to school every day, however we understand that occasionally a student may need to borrow from our limited school device library. A loan device is available for day loan if the student's device is being repaired or replaced or for another short term reason. This form needs to be completed by the student's caregiver prior to the student requesting to loan a device from the Library as no device will be issued without completion of this form.

By completing this form, you are accepting liability for any damage caused to the device while it is in your student's possession. Devices must be returned to the Library at the end of each day.

Email *

Student Name *

Student's Whanau Class *

Date Loan Device Required *

YYYY

Number of days device required (max 5) (If more than 5 days is needed please contact info@kaipara.school.nz) *

Reason for Loan *

Caregiver First Name *

Caregiver Last Name *

Caregiver Email Address *

Caregiver Phone Number *

Acceptance of Liability

I undertand that by submitting this request for the student named in this form to borrow a device from Kaipara College, I accept liability for any damage or loss of the loan device.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Kaipara College. Report Abuse

Forms