Student Device Checkin

Student Device Checkin
Name *

First Name Last Name
Grade *
Device Serial Number *
Found under the Settings, then General, then About
What is the current state of the Device *

Ready for next year Broken or damaged screen that needs repaired Software problems
Please describe the damage and how it occurred
Please describe problems that you are having with it
Are you returning a charger? *

Yes No
I understand that I am liable for replacing this charger

Yes
Is there any other information that the technology department might need to know about your Device?
8th Period Teacher *
Signature *

Clear
Date *

Month Day Year
Should be Empty: