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* 1. I have reviewed the District 209 Technology Use Policies and Guidelines and acknowledge that my student and I will follow these policies and guidelines while in possession of the laptop.

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* 2. I acknowledge that my student will be issued a laptop and its components (power cord, adapter, pen, etc.) are for educational and research purposes only.

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* 3. I understand that my student is responsible for charging the laptop at home each evening and bringing it, along with its components (power cord, adapter, pen, etc.), to school daily.

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* 4. I acknowledge that in the event my student’s laptop is lost or stolen, a police report, detailing the circumstances of the incident, must be filed and a copy provided to school administration within twenty-four (24) hours of the discovery of the theft or loss. Following this timeframe will result in District 209 covering the cost of replacement of the laptop and its components (power cord, adapter, pen, etc.). Failure to follow the timeframe will result in our family being responsible for replacement costs.

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* 5. I acknowledge any damage to my student’s laptop will be assessed on a case-by-case basis. If the damage is determined to be accidental or covered by warranty, District 209 will ensure that that the repairs are made to the laptop. If it is determined that the damage is due to gross negligence, our family will become financially responsible for the cost of replacement of the laptop and its components (power cord, adapter, pen, etc.). I also understand that all replacement parts and repairs must be purchased and performed by District 209 and its technical staff.

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* 6. I acknowledge that violation of the District’s Acceptable Use Policy can result in disciplinary action, including, but not limited to, loss of technology privileges, loss of use of the laptop, and standard District 209 discipline consequences for my student.

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* 7. I acknowledge that District 209 owns the legal title of the laptop and its components (power cord, adapter, pen, etc.) issued to my student.  Therefore, in the event my student withdraws from enrollment at District 209 or has his or her privileges terminated, any technology issued to my student must be returned to the school immediately.  Failure to do so can result in our family incurring replacement costs.

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* 8. Please enter your electronic signature and phone number.

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* 9. Please enter your email address.

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* 10. Please select the date of your submission.

Date

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* 11. Please enter your student's ID number.

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* 12. Please enter your student's first and last name.

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* 14. Please include any questions/comments you may have:

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