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Remote Learning Device Request

Please complete the form below. Required fields marked with an asterisk *

Remote Learning Device Request

I need:
If you need both, please complete a separate form for each.
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Parent/Guardian Information

Contact Information
Relationship to Student*
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Does the student have access to a computer?*
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Does the student have internet access?*
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Student Information

 
Question
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School Name*
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Address
State*
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Grade level*
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Does the student live in a shelter?*
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Does the student’s family live with another family or other person because of loss of housing or as a result of economic hardship?*
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Is the student currently in foster care?*
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Does the student live in NYCHA housing?*
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I understand that I am permitted only 1 device per student. I understand that the school has a record of all devices which were distributed, even those devices which were mailed home to families in the Spring of 2020. *
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I prefer the following device:*
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Student Device Agreement

Students in need of remote learning can be issued a device for their educational use. If reasonable precautions and care are taken in the use of the device, the laptop should not experience physical damage. Each parent/guardian should review this form carefully with their child.

All devices issued to students are to be used to access remote learning and other educational uses. Students are expected to follow the guidelines below and take any additional common sense precautions to protect the device. Students are responsible for taking care of the device. The policies outlined in this document are intended to cover all available technologies, not just those specifically listed.

By accepting this equipment I agree to ensure that my child adheres to the following:

Return of Device

This device is being loaned for the student’s use during remote learning. This device is the property of the NYCDOE and contains a tracking device so that the device can be located. This device must be returned when on-site learning resumes, unless otherwise instructed by the NYCDOE.

Care and Maintenance

  • The student/family is responsible for the daily care and maintenance of the laptop. Any damage or theft must be reported to the NYCDOE within one school day.
  • Keep the laptop in a safe place when not in use.
  • Students/families should report problems to 718-935-5100 or 311. Do not attempt to remove, add, or change the physical structure of the device, including keys, memory, battery, screen, charger, ID labels, etc.
  • Carry the device carefully at all times. Do not store items on top of the device.

Usage Guidelines

In general, all students are expected to use good judgment and common sense; be safe, appropriate, careful and kind online; not attempt to get around technological protection measures; and ask an adult if they need help.

Student Acceptable Use Guidelines

Students must:

  • Use the device provided only to access remote learning activities.
  • Follow the same guidelines for respectful, responsible behavior online that students are expected to follow offline.
  • Treat this device carefully, and alert the helpdesk there is any problem with the operation.
  • Understand that this equipment is property of the New York City Department of Education and should be treated as such. If equipment is stolen, a police report must be filed.
  • Alert a teacher or other staff member if students see threatening, inappropriate, or harmful content (images, messages, posts) online.
  • Be cautious to protect the safety of the student and others.
  • Help to protect the security of school resources.

Students must not:

  • Attempt to bypass the school’s mobile (internet) filter.
  • Use this device in a way that could be personally or physically harmful.
  • Attempt to find inappropriate images or content.
  • Engage in cyberbullying, harassment, or disrespectful conduct toward others. Such conduct will result in disciplinary action and loss of privileges. In some cases, cyberbullying can be a crime.
  • Try to find ways to circumvent the school’s safety measures and filtering tools.
  • Use school technologies to send spam or chain mail.
  • Use language online that would be unacceptable in the classroom.
  • Use school technologies for illegal activities or to pursue information on such activities.
  • Attempt to hack or access sites, servers, or content that isn’t intended for student use.
  • Alter a school’s device hardware or installed software.

Personal Safety and Privacy

  • Users should never share personal information, including phone number, address, social security number, birthday, or financial information, over the Internet without adult permission.
  • Users should recognize that communicating over the Internet brings anonymity and associated risks, and should carefully safeguard the personal information of themselves and others.
  • Users should never agree to meet someone they meet online in real life without parental permission. If students see a message, comment, image, or anything else online that makes them concerned for their personal safety, they should bring it to the attention of an adult immediately.

Limitation of Liability

The NYCDOE will not be responsible for damage or harm to persons, files, data, or hardware. Devices employ filtering and other safety and security mechanisms, but there is no guarantee as to their effectiveness. The NYCDOE will not be responsible, financially or otherwise, for unauthorized transactions conducted over the school network.

I agree to the above Student Device Agreement*
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Confirmation Email