Device Return

Parent Name(Required)

First Last

Please list the name of the parent/guardian that completed the enrollment application.

Email(Required)

Phone(Required)

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Would you rather have the shipping label mailed to the above address or emailed to you?(Required)

Mailed to Above Address

Emailed to Above Email Address

Will you be returning an internet device (mifi)?(Required)

Yes

Number of Chromebooks Being Returned

Name of Student(s)(Required)

List the name(s) of the student(s) that were assigned a Chromebook

Name

This field is for validation purposes and should be left unchanged.

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