School District of Westfield
Personal Technology Bring Your Own DeviceAgreement
Turn completed form in to your school office
Student Name(please print)______
Student ID #______
Parent Name(please print) ______
Personal Technology Device Information
Brand Name/Model:______
Serial Number:______
Personal Technology Device Information
Brand Name/Model:______
Serial Number:______
Personal Technology Device Information
Brand Name/Model:______
Serial Number:______
I/we have read the School District of Westfield (SDOW) Bring Your Own Device Policy form concerning the use and connection of private technology devices (PTDs) to the SDOW wireless network and understand and agree to the terms and conditionsherein.
I/we understand that this policy form and the privilege to use PTD’s in school can be revoked at any time.
I/we have signed and returned the School District of Westfield Acceptable Use Policy for the student indicated below.
I/we understand that violation of these provisions may result in the confiscation of a PTD by the school administration, any other designated school division representative, or local law enforcement and that legal action may occur according to law.
I/we understand that we are responsible for compensating the school for any losses, costs or damages incurred due to violations of SDOW Board policies/procedures and school rules by the student in conjunction with the use of his/her PTD, including the cost of investigating such violations.
______I/we give permission for my student, to use a personal technology deviceon the wireless network in the School District of Westfield.
______I/we DO NOT give permission for my student, to use a personal technologydevice on the wireless network in the School District of Westfield.
I understand the above rules and policy for connecting a personal technology device to the wireless network in the School District of Westfield and agree to follow the rules outlined.
Parent Signature ______Date ______
Student Signature ______Date ______
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