Westbrook Walnut Grove Schools Internet/Network Acceptable Use Policy
**Please fill out this for for each of your students separately**
Grade
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Student Name
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First Name
Last Name
Student Signature
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Parent Name
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First Name
Last Name
Parent Signature
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**Please fill out this for for each of your students separately**
Student Name
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First Name
Last Name
Student Signature
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Parent/Guardian Signature
*
Please choose payment option
*
I will be using a school-issued device and agree to pay $35 to cover any accidents that may occur according to the 'Insurance' paragraph above. I will pay now online.
I will be using a school-issued device and agree to pay $35 to cover any accidents that may occur according to the 'Insurance' paragraph above and will pay with cash or check at the school before Oct 4, 2024.
I decline to pay $35 and will cover any cost due to any accidents according to the 'Insurance' paragraph above.
I will be providing my own device and agree to the 'Personal Device' paragraph above.
Technology Fee (a 2.9% service charge will be added to total if paying online)
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Technology Fee
$35.00
$
35.00
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Credit Card
***If you would like to pay for more than one student during this transaction please note the name of the students being paid for below and change the quantity in your transaction. Please note, this form must still be filled out for each student. For other students please mark will pay later.
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