Device Request during COVID-19 School Shut Down
Please add your information to this form if your student needs access to a device.  You will be contacted with information on how to borrow a device from the district that will be returned when school resumes.  If you have secondary aged students in your household, additional devices will not be provided.  

Please know that you will be contacted by a Mt. Pleasant staff member to pick up a device.  They will be at the Middle School on Mondays through Thursdays from 1:00-3:00 PM.
Sign in to Google to save your progress. Learn more
Parent Name (first and last name) *
Student's Name-list all students in household: *
What is your cell phone number? *
What is your email?
What grade is your student in? (Check multiple boxes if you have more than one child in your household) *
Required
What building is your child in? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mt. Pleasant Community School District. Report Abuse