Parent / Student Technology Support Form

Parent / Student Technology Support Form
Student Name*

First NameLast Name
If we need to contact you, what is the best phone number?*
Format: (000) 000-0000.
Email - Confirmation of your support ticket will be sent to this address*
example@example.com
Lewis Cass ElementaryLewis Cass Junior HighLewis Cass High School
K-2 (iPad)3-12 (Chromebook)
My laptop has a hardware/physical issue (Not charging, broken screen, etc)I'm having trouble with a program or online textbookI'm not receiving emails or text messages
Name of the program you having trouble using?*
Who is your teacher?*
What is the class name or period?
What is your issue? For the all call system, please list the email and/or phone number. Please provide any error messages*
Parent/guardian's name that is expecting to get emails and/or texts?

First NameLast Name
Text messages from the district or schoolEmails from my students teachers
What email address are you expecting to receiving emails on?
example@example.com
What phone number are you expecting to receive texts on?
Should be Empty: