CRES Chrome Insurance Registration00

Chrome Insurance Registration

Globe Unified School District
A Chromebook Insurance plan covers all electrical and mechanical failures that occur during normal use of your item. The Chromebooks are covered up to the full purchase price. Some examples of covered issues include a blank screen, hard drive failure, manufacturer defects, or other issues resulting from accidental damage, misuse, or abuse. It is important to report any problems with the Chromebook to the Globe USD Technology Department at Extension 6069 or 6098. Claims processing will be taking care of by the Globe Unified School District.
Student Information

Please enter the student who will be assigned the chromebook for day to day use.
Student First Name *
Student Last Name *
Student Grade Level
Student ID Number (Lunch number, if known)
Campus student will use Chromebook at *
Account & Billing Information
Email *
example@example.com
Billing First Name *
Billing Last Name *
Phone Number *
Please enter a valid phone number.
Billing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Payment Status

Please indicate what status you fall under for payment of your Chromebook. PLEASE NOTE DISTRICT OWNED CHROMEBOOK WILL NEED TO BE RETURNED AT THE END OF THE SCHOOL YEAR, OR IF THE STUDENT LEAVES THE SCHOOL DISTRICT.
Payment Status *

Free Lunch $10.00 Reduced Lunch $15.00 JOM $0.00 Full Amount $25.00
Next Steps

After completion of this online form, please have the parent report to the school location where Chromebooks will be disbursed. The parent will need to have CASH to pick up the Chromebook. If the student is JOM, the student will need to show proof of CIB number. The campus will verify your completion of this form to process the payment and release of the Chromebook.
Should be Empty:

Chrome Insurance Registration

Student Information

Account & Billing Information

Payment Status

Next Steps