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KHS Chromebook/Hotspot Parent Request - SY 2021-22
This form is to request a Chromebook to be assigned to your student. Other required forms will follow. All fields must be completed.
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Grade
9
10
11
12
Clear selection
Student SLC
*
3DE
ISGL
Fine Arts
Technology
First Block Teacher (If Virtual write "Virtual")
*
Your answer
Second Block Teacher (If Virtual write "Virtual")
*
Your answer
Is your student registered for Virtual School (Online ) Only?
*
Yes - Virtual School (Online Only)
No - Face to Face in School
Student 7 Digit ID Number
*
Your answer
What are you requesting?
*
Hotspot
Chromebook
Are you signing up for a replacement device?
*
Yes
No
Does your student already have a DCSD Issue Chromebook?
*
Yes
No
Does your Student have an IEP or 504 on file? (If you do not know what this is, then answer no.)
*
Yes
No
Parent Name
*
Your answer
Parent Contact Number
*
Your answer
Parent Mailing Address
*
Your answer
Enter the Parent Email Address that is checked - All Information Will be Communicated Here Only
*
Your answer
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