Parent Consent Form Chromebook Take Home Program Student access to computers is one way that Fairfield County School District 1:1 Digital Learning Initiative (DLI) enhances the learning opportunities for our students. Use of the device is a privilege. Students who are issued a computing device are expected to follow Fairfield School District’s policies, procedures, and practices. These are available in hardcopy and on the district’s website. Students and parents who choose to have a device go home with a student are encouraged to purchase a prepaid device protection plan. The cost of the Protection Plan is $25.00 annually and is non-refundable. The 1:1 DLI fee has been implemented for the 2016-2017 school year. While there is no cost for the use of the device, it is imperative that the device assigned to the student be maintained and handled in a responsible way. For any student who has a financial hardship, the student can request payment adjustments though the school administration. Purchasing the protection plan is in the best interest of the students, families, and the district. In order to sustain the 1:1 initiative, we must insure against losses, and the protection plan helps us to do that. Families may opt out of the protection plan, but if the device is damaged, the parent/guardian is liable for the full cost of the repair or replacement of the device. If the district determines that the device was damaged due to misuse or neglect, the protection plan will not be applicable and the cost to repair or replace the device will be placed on the student’s account until the debt is paid in full. The Parent/Guardian will be notified by mail of any fees applied to their student’s account.

Repair and Replacement Costs Damage often results in multiple component repairs. For example, severe damage may result in damaged glass, LCD/Digitizer, system board and other components all at once, so the repair cost may be a combination of several items, and in some cases, replacement is cheaper. To publish predictable repair costs, to reduce the potential burden to students and parents, and to simplify the assessment of costs, the cost schedule has been generalized into simply major and minor repair costs. Costs are based on our current models of the Chromebook. It is likely that lower cost options are available through some outlets, but we cannot accept substitutes, which typically lack required features or licensing. Replacement

Cost

Replacement Device - Lenovo Chromebook

$350.00

Repair

Cost

Screen/Display, System Board, Antenna, Keyboard, Plastics, Fee Varies Buttons, Battery Replacement Items

Cost

Power Adapter and Cable

$20.00

Protective Carry Case/Sleeve

$25.00

School Protection Plan Options Take Home Section I (Choose One). (1) Opt in - take-home protection plan _____ My son or daughter, __________________________________, has permission to bring their assign Chromebook home and I will opt in and purchase the protection plan. I understand the protection plan does not cover the power adapter or charger damage or neglect or abuse for which my child will be assessed the full cost of repair or replacement for ALL incidents. (2) Opt out - take-home protection plan _____ My son or daughter, __________________________________, has permission to bring their assigned Chromebook home and I will opt out of purchasing the protection plan. I understand that my child will be assessed the full cost of repair or replacement for ALL incidents. Section II. _____ I have reviewed and completed the Chromebook Procedures Guide and understand that my student is expected to follow FCSD’s policies, procedures and practices as outlined in the Chromebook Procedures Guide. _____ I understand that while there is no cost for the use of the device, it is imperative that the device the student is issued be maintained and handled in a responsible way. If any damage occurs, students will be assessed the full cost for repair. To avoid this cost, the device protection plan will need to be paid in advance. Student’s Name: _______________________________ Student’s Signature: ____________________________ Date: __________ Parent/Guardian’s Name: ________________________ Parent/Guardian’s Signature: ______________________ Date: __________ Last Year’s Homeroom Teacher: __________________________________ School (Circle One):

FMS

FCHS

GOA Grade (Circle One): 7 8 9 10 11 12