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Student Technology Request Form
Please use this form to submit any requests for devices from students/families.
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* Indicates required question
Student FirstName
*
Your answer
Student LastName
*
Your answer
Grade
*
Choose
K
1
2
3
4
5
6
7
8
9
10
11
12
Homeroom Teacher
Your answer
Does student have internet at home?
*
Yes
No
Parent/Guardian Name
Your answer
Parent/Guardian Email Address
Your answer
Staff Member Submitting Request (if applicable)
Your answer
Submit
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