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Cooke RCCSD 1:1 Technology Agreement (SY 21-22)
Please answer all questions below and click submit when complete. One submission is required per student if you have multiple students in grades K-12 in the Red Clay Consolidated School District.
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* Indicates required question
Email
*
Your email
Family Information
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's Lunch ID Number
*
Your answer
Parent/Guardian's First Name
*
Your answer
Parent/Guardian's Last Name
*
Your answer
Parent/Guardian's Email Address
*
Your answer
Parent/Guardian's Phone Number
*
Your answer
Student's 2021-2022 Grade Level
*
Choose
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Student's School (If your student does not attend Cooke, please see your student's school website for the correct technology agreement. This form is for Cooke students only).
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Your answer
Technology Usage Agreements
We (Parent/Guardian & Student) have reviewed and agree to Part 1 of the 1:1 Technology Usage Agreement (
https://www.redclayschools.com/Page/3215
)
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Yes we have/do.
Required
We (Parent/Guardian & Student) have reviewed and agree to Part 2 of the 1:1 Technology Usage Agreement (
https://www.redclayschools.com/Page/3215
)
*
Yes we have/do.
Required
Accidental Protection Plan Participation
Based on Information from Part 2 of the 1:1 Technology Usage Agreement, decide how you will participate in the RCCSD Accidental Protection Plan by making a selection below.
Parents/Guardians must choose one of the four options below.
*
I paid the $20 insurance fee on PayPams. Instructions:
https://www.redclayschools.com/Page/3215
I will send the program fee of $20 to my student's school. Cash or check is accepted. Please make checks payable to Red Clay Consolidated School District.
I understand the RCCSD Chromebook Accidental Protection Plan is for my student’s Chromebook. Please contact me to set up a payment plan option.
I have further questions. Please contact me regarding this fee.
Required
Electronic Signatures
By electronically signing this agreement, Student and Parent/Guardian agree to Part 1 and Part 2 of the 1:1 Technology Usage Agreements, the RCCSD Acceptable Use Policy, and the Student Code of Conduct.
Student Signature: Please type your first and last name in the field below. This serves as your electronic signature.
*
Your answer
Parent/Guardian Signature: Please type your first and last name in the field below. This serves as your electronic signature.
*
Your answer
Parent/Guardian Relationship to Student
*
Mother
Father
Separate Legal Guardian
Other:
Send me a copy of my responses.
Submit
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