Technology Use School Permission Form
Please complete the Technology Use School Permission Form to grant or deny permission for your student to use school technology resources.
Student's Full Name
*
First Name
Last Name
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Student Grade/Year
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Other
Teacher or Homeroom
Please read and acknowledge the school's technology use policy. Do you grant permission for your student to use school technology resources (computers, internet, educational software) under school supervision?
*
Yes, I grant permission
No, I do not grant permission
Comments or special instructions (optional)
Parent/Guardian Signature
*
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Permission
Submit Permission
Should be Empty: