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Chromebook Student/Parent Agreement Form
Parents:
Please fill out this survey separately for EACH CHILD who is receiving a Chromebook. At the end of this agreement, hit submit and it will have a link to make your payment through the Sting Store.
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* Indicates required question
Parent/Guardian Last Name
*
Your answer
Parent/Guardian First Name
*
Your answer
Student Last Name
*
Your answer
Student First Name
*
Your answer
Student Grade
*
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Do you want the available insurance policy?
*
YES, I want the available, non-refundable, $25 insurance policy for the Chromebook. Families that fill out the Application for Educational Benefits Form and who qualify for Free/Reduced lunch, will be issued a refund check.
NO, I choose not to pay the fee. I understand that I/we are responsible for all repairs and the device cannot leave the YME MS/HS building.
Do you have reliable wireless internet access at home?
*
Yes
No
Have you read, understand and agree to the 1-to-1 Acceptable Use Policy?
*
YES
NO
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