Elementary Parent Request for Home Use of School Device

My child attends    Please Select Cherry Park Elementary Ebenezer Elementary Ebinport Elementary Independence Elementary India Hook Elementary Lesslie Elementary Mount Gallant Elementary Mount Holly Elementary Northside Elementary Oakdale Elementary Old Pointe Elementary Richmond Elementary Sunset Park CAS York Road Elementary *   

My child is in the    Please Select 5K 1st 2nd 3rd 4th 5th *   grade.

I request for my child, First Name*   Last Name*   , to bring home his/her school issued laptop for the purpose of       for the time frame of   Date*   through   Date*  (Not to exceed 5 consecutive school days) .

Reason for home use: Reason    

*I understand that the parent/student is responsible for the care of the laptop, charger, and case, including physical mishandling and accessing unauthorized sites. I may incur financial penalties if the laptop is intentionally damaged under my care.

Technology Charges:
Damaged Keyboard $85
Damaged Touchscreen $85
Case $18
Charger $40
Replacement (Price may Vary)

*It is the responsibility of the parent and student that the laptop and charger is brought to school each day although the student has permission to the laptop home.

*Timeframe should not extend five consecutive school days. A new request should be completed if further time is desired. 

Parent   First Name*   Last Name*   
Parent Email   Email*   
Parent Phone Number   Area Code*   Phone Number*