Chromebook Distribution Form

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

Adams Middle School

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Parent/Guardian email address: *

If you will not be collecting the device, please list an alternative pick-up person:

Please list all of your students attending this school.

Note: Please only include students attending this building; if you have students in multiple schools you will have to fill out the appropriate forms corresponding to those buildings.

If you have more than 3 students attending this building, you will have the opportunity to resubmit this form again and add the remaining student(s).

Student 1 Name: *

Student 2 Name:

Student 3 Name:

Clear form

Never submit passwords through Google Forms.

This form was created inside of Wayne Westland Community Schools. Report Abuse

Forms