SLCUSD Device Checkout Agreement 2021-22
SLCUSD strives to utilize technology for educational purposes when appropriate. All students/parents/guardians will be required to complete this form only if the technology equipment is to be taken from a District facility. Technology equipment may be checked out under the provisions of the SLCUSD Responsible Use Policy and with agreement to the following conditions:

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Email *
By completing this form, I/we acknowledge and agree as follows:
1. All use of the District's technology equipment will be for educational purposes. At no time will the equipment be used for personal, commercial or business use.
2. Provide consent for school district to access all district-owned electronic devices and the information created by those devices.
3. To abide by and adhere to all copyright laws.
4. To use ordinary care and diligence in  safeguarding and supervising use of the equipment & returning it to the District in the same condition it was in prior to checkout; and to assume liability for any damage, loss, or theft of the equipment while in my care.
5. To immediately report any damage, loss, or theft to school site personnel.
6. To participate in training in the use and care of technical equipment, as provided by the appropriate school staff member prior to checking out the equipment.
7. To return the technology equipment to the school as required by the teacher or administrator:
a. On or before the due date on this agreement;
b. Prior to the due date if requested by the authorizing supervisor/teacher;
c. When withdrawing.
8. To pay for the replacement cost in the case of damage or loss. A Chromebook replacement cost will be $280. (includes the $20.00 cost of a charger)

Student's Last Name *
Student's First Name *
Parent/Guardian Full Name *
Phone Number: * Please include the best number for us to reach you. *
Please tell us what devices(s) are needed for the 2021/22 school year *
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