Please Read the Entire Agreement then scroll to bottom section to Electronically Sign and Submit.
(Please allow up to 24 hours for submission processing.)
Parent/Guardian Printed Name
*
First Name
Last Name
Parent/Guardian Signature
*
Parent/Guardian Telephone Number
*
Please enter a valid phone number.
Parent/Guardian Email Address
*
Confirmation Email
Enter a Personal and private Email address only! No work Email address should be used.
Student Name (used as valid student signature)
*
First Name
Last Name
NOTE!
This form is for students in grades 7-12. One2One devices to take home, for students in grades K-6 are assigned for approved circumstances only.
Student Grade Level (grade entering in August 2025)
*
7
8
9
10
11
12
English Language Learner
Special Ed
Home Instruction/Other
Unique Code
*
Submit
Should be Empty: