Warwick Institute Technology Device Request Waiting List SY2020-2021
Please complete this form to be placed on the waiting list for a loaner Chromebook for your Warwick Institute student during Remote Learning.  A confirmation email/ message will be sent to you, once a device becomes available and you will be scheduled to come to Warwick to pick-up the device.  Please do NOT come to the school, until you are scheduled to do so. Only a parent/ guardian is allowed to pick-up the device(s). You will be required to show a valid picture ID and complete the EO School District Equipment Release form and the Warwick Institute Loan Agreement. There is a $400 replacement cost for lost, stolen, or damaged devices. You will receive an emailed copy of this request. Thank you.
Sign in to Google to save your progress. Learn more
Email *
Parent/ Guardian Last Name: *
This should be the last name of the person who will be picking up the device(s).
Parent/ Guardian First Name: *
This should be the first name of the person who will be picking up the device(s).
Parent/ Guardian Contact Telephone Number *
Please provide a valid telephone number where you can be reached, if needed. Numbers only, no dashes.
Full Name of STUDENT *
Please only enter ONE name. You must complete complete this form for EACH student who needs a device.
Do  you have access to the Internet for Remote Learning? *
Student's Current Grade for 2020-2021 *
Current Teacher's Name for 2020-2021 *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of East Orange School District. Report Abuse
Google Forms