Acknowledgement of Mobile Device Decline OR Need

International Studies Preparatory Academy

Acknowledgement of Mobile Device Decline OR Need
Student Name:*

First NameLast Name
Student ID #:*
Grade Level:*

9th Grade10th Grade11th Grade12th Grade
PLEASE SELECT OPTION 1 OR OPTION 2:

OPTION 1: By selecting this option, you acknowledge your child DOES NOT NEED an M-DCPS Mobile Device and you DECLINE checking out a Mobile Device. Furthermore, you understand that in the future, if your child needs a Mobile Device, it can be requested.OPTION 2: By selecting this option, you ARE requesting a mobile device for your child.
Click on the link below if you would like to purchase
insurance for a device issued to your student.

https://securranty.com/dadeschools
Student Signature:*

Clear
Parent/Guardian Name:*

First NameLast Name
Parent/Guardian Signature:*

Clear
Parent/Guardian Email Address:*
example@example.com
Parent/Guardian Contact Number:*
Please enter a valid phone number.
Date*

MonthDayYear
Date
Should be Empty:

International Studies Preparatory Academy