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Student's First Name

Student's Last Name

Student Device

Chromebook

iPad

Issue

Device charger is broken or isn't working

Device was dropped (Damaged)

Spilled liquids on device (Damaged)

Apps aren't working or is missing apps

Device doesn't turn on

Other

Please describe the issue

Parent Contact Information

First Name

Last Name

Phone

Email Address

Best way to contact you

Morning by Phone (8 A.M. to 11:59 A.M.)

Afternoon by Phone (Noon to 4:30 P.M.)

By Email

Other

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