Sugar Creek Charter School - High School- High School Technology Device Usage Agreement

Sugar Creek Charter School Technology Device Usage Agreement

(For High School Students ONLY)
This form can be completed online by scanning the below QR code to complete the form digitally.

If you are completing this form online, Please "X" and complete the below sections. And return this sheet with your student.

___ I have complete the online version for:

Student Name: ___________________________________

Grade: ______
If you do not wish to complete the online version, please complete all sections of the form, providing a copy of your State/Government/Federal ID, and return the form to the school.
Student Information
Full Name *

Last Name First Name
Grade Level *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent Information
Name *

First Name Last Name
Email
example@example.com
Phone Number *

Area Code Phone Number
*

Laptop inspection is done prior to distribution. I understand that damaged, lost, or stolen, the laptop will be the financial responsibility of the parent(s)/guardian(s). I understand any unpaid fees will also restrict access to academic documentation (i.e. report cards, transcripts). I consent to my student checking out a laptop. The laptop is the property of Sugar Creek Charter School. In the event that remote learning occurs, I certify that I would be unable to sufficiently participate on remote learning and/or complete internet-based homework assignments if an (iPad, Chromebook, or laptop) was not provided by Sugar Creek Charter School.
Parent /Guardian Signature *

Clear
Date *

Month Day Year
Date
ID REQUIRED:
Please include a copy of the parent/guardian's government-issued ID or driver's license. (A copy of ID is required with this agreement.)
Please be advised a school representative will call to verify the parent/guardian's signature.
Upload a picture of your government issued ID or driver's license. *

Browse Files

Cancel of
Take Photo *
Technology Usage Fee:

There is a $45.00 Technology Usage Fee. This fee allows students to use technology devices for instructional purposes throughout the school year. We would like for all fees to be paid by the week students return to school. The final deadline for the usage fee is Friday, August 26, 2022. Non-Payment will prohibit a students' use of technology. Please send this form and the $45.00 Tech usage fee to the school with your child. All required fees must be paid in cash. (Credit/Debit/money orders or checks will not be accepted.)
Device Fee Sheet

Please review the fees. Fees will be charged for lost/stolen or damaged devices.
For Authorized Personnel Only
Checked By:
Signature

Clear
Technology Fee:

Paid Date Paid_____________ Collected by: ___________________________ Receipt # _______________________________ Entered into Powerschool
Date:
Item Type:

Lenovo Laptop Charger
Serial #
Asset Tag(s)
Check-Out Date
Return Date
Should be Empty:

Sugar Creek Charter School Technology Device Usage Agreement

Device Fee Sheet