IJNDB-E1: STUDENT COMPUTER INTERNET USE ACKNOWLEDGEMENT FORM

No student shall be allowed to use school computers/laptops/tablets or the Internet until the student and a parent/guardian have signed and returned this acknowledgement to the school.  This acknowledgement is to be signed at the initial grade at each building level or when a student first enters the Kittery School Department, and then at the initial grade at each building level thereafter. 

Student:

I have read the policy- Student Computer/Internet Use and Student Computer/Internet Use Rules, and I agree to comply with them.  I understand that a violation of this policy and rules may result in having my computer privileges limited, suspended or revoked.  A violation may also result in disciplinary action, referral to law enforcement and/or legal action.

Signature of Student: 

Date:

Parent/Guardian:

I have read the policy- Student Computer/Internet Use and Student Computer/Internet Use Rules and understand that my child’s use of school computers/laptops/tablets is subject to compliance with them.

Print Name of Student:

Signature of Parent/Guardian: 

Date: 

SCHOOL:

GRADE:

TEACHER: 

Reviewed PC:   January 28, 2013