Damage to Devices

Damage to Devices

2024-2025
Your student is to participate in the PM Wells Charter Academy Digital Learning Project; you and your student are listed as device holders per the agreement. Any damage, lost or stolen devices can result in compensation for damages by the student’s family.

Please select the device damaged by your scholar in this 2024-2025 school year.
Student Name

Student First NameStudent Last Name
Student ID Number
Student ID Number
Grade
Grade
Homeroom Teacher
Homeroom Teacher
Room
Room
Parents Name

Parent First nameParent Last Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
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Broken Screen
$100.00 Quantity

Lost or Stolen iPad
$400.00 Quantity

Total

$0.00
Assessment Fines are due to the school at the time of receipt.
If unable to remit the total assessed fine due, please contact the school administration.

Requests for the actual cost of repair or replacement should be directed to the school administration.
Should be Empty: