Mobile Technology Acceptance Form

Mobile Technology Acceptance Form

Student’s Name__________________________________ Grade ______

Mobile Technology Acceptance Form

● I understand that all mobile technology devices, equipment, and/or accessories the District/school has provided to me are the property of Dillon School District Four.
● I agree to all of the terms in the District Tablet Procedures Guide and in the District’s other policies relating to technology use.
● I will return the equipment to the District/School in the same condition in which it was provided.
● I will not install any malicious or damaging software or change the configuration of the equipment in any way.
● I will not allow any other individuals to use the device and/or related equipment and accessories provided by the District/School.
● I understand that any violation of the terms and conditions contained in the District’s technology policies may result in the restriction and/or termination of my use of District Issued Mobile Devices, equipment, and/or accessories, as well as possible disciplinary action.
● I understand that I am personally and financially responsible for any damage to the District Issued Mobile Device and/or its related equipment and accessories that might occur from non-school related use or due to user negligence as deemed by the school’s administration and District Technology Department.
● I understand that I am personally and financially responsible for the loss or theft of any such District Issued Mobile Device and/or related equipment and accessories.
● I understand that I have no expectation of privacy in my use of the District Issued Mobile Device and that the District may, at any time it deems necessary, examine all materials contained on such computers.
________________________________________

Student’s Name (Print) _________________________________________________________

Parent’s Name (Print) _________________________________________ Date_____________

Parent’s Signature_____________________________________ Phone __________________



ITEMS LOANED - If used or damaged please make additional comments

Device Type_________________________________ D4 Asset #________________________

Device Type_________________________________ D4 Asset #________________________



Technology Fee Paid ______________________ (Date) Receipt Number _________________
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