You are here

Code No. 606.1E2 Student Appropriate Use Form

Student Appropriate Use Form

Name:                                                                         Graduation Year:                               

User Name:                                                                 User Password:                                  

Equipment                                                                  Check-In                     Check-Out

                                                                                   

Computer/Tablet

Asset Tag #:                                       

Serial #:                                              

Carrying Case

Power Supply & Cord

 

                                                                                                                                                  

Parent/Guardian Signature                                 User Signature                      User Signature

                                                                                                                                                   

Date                                                                    Admin. Signature                  Admin. Signature

I am the parent or guardian of the above student.  I hereby certify that I have received, read, understand and agree to the Interstate 35 Community School District’s Appropriate Use of Technology Policy.

I understand that the laptop computer and/or tablet and related equipment the above-referenced student is being issued is the property of the Interstate 35 Community School District.  My student will return the laptop computer and/or tablet and any related equipment he/she is issued in the same condition in which he/she receives it, excluding normal wear and tear and unforeseen system breakdowns, i.e. hard drive failure, etc.

I understand that the district has insurance coverage that may cover the cost of repairs to the laptop and/or tablet.  I understand that my student and/or I may be responsible for and/or assessed a fee for any damage or loss of any component of the laptop computer, tablet, and/or related equipment. In case of damage or loss, I agree that my student and/or I may be required to reimburse the district for and/or pay a fee for any damaged or lost component and/or equipment with components.

I recognize that although the Interstate 35 Community School District has taken measures to restrict access to controversial materials, it cannot guarantee that students will be protected from accessing any controversial materials during the student’s use of the district’s technology, network systems, and the internet.

I accept full responsibility for my student’s use of the district’s technology, network systems, and the internet through the district in accordance with the terms, conditions, and guidelines as stated by the district in its policies and regulations and as set out in federal and state law.  I relieve the Interstate 35 Community School District and its officers and employees, from any and all financial responsibility that may be incurred by my student’s use of the district’s technology, network systems, and the internet.

My student may take his/her computer/tablet home with him/her.: _____ Yes        _____ No

My student may have access to internet.: _____ Yes _____ No

My student may be issued or create an account for internet services, including but not limited to, a Google account.:_____ Yes ____ No

I hereby give the district permission to publish my student’s work, picture, and/or first name on the internet through the district’s web site and/or other online forums._____ Yes          ____ No

 

____________________________                                        __________________

Parent/Guardian Signature                                                     Date

 

If you have consented to your child’s use of the district’s technology, network systems,  and internet access, please have your child review and sign the following:

I have read the Interstate 35 Community School District’s Appropriate Use of Technology Policy and agree to abide by its provisions.  I understand that violation of these provisions will result in the restriction and/or termination of my ability to use the district’s technology, network systems, and internet access and may result in further discipline up to and including expulsion and/or other legal action.  I agree to be responsible for payment of costs incurred by accessing any internet services that have a cost involved.

I understand that the laptop computer, tablet, and/or related equipment I am being issued is the property of the Interstate 35 Community School District.  I will return the laptop computer and/or tablet and any related equipment I am issued in the same condition in which I receive it, excluding normal wear and tear and unforeseen system breakdowns, i.e. hard drive failure, etc.

I understand that the district has insurance coverage that may cover the cost of repairs to the laptop.  I understand that I may be responsible for and/or assessed a fee for any damage or loss of any component of the laptop computer, tablet, and/or related equipment. In case of damage or loss, I agree that I may be required to reimburse the district for and/or pay a fee for any damaged or lost component and/or equipment with components.

____________________________                                        __________________

Student Signature                                                                   Date

 

Approved:  March 15, 2004

Revised/Reviewed: September 29, 2015