Acceptable User Policy Computer/Internet ... - Waverly Schools

Acceptable User Acceptance FormFor Computer/Internet TechnologyWaverly Community Unit School District201 N. MillerWaverly, Illinois 62692I have read and understand the Waverly Public Schools District AcceptableUser Policy for Computer/Internet Technology and agree to comply with therights and responsibilities contained in that document. I understand the failure tofulfill my responsibilities as they relate to the use of computer/Internettechnologies in the school district may result in disciplinary action. I furtherunderstand, failure to repay the district for computer misuse will result in thenonissue of another computer the next year, or if the student is a senior, loss ofgraduation privileges.Print Student/Staff Name: ________________________________________________Student/Staff Signature:__________________________________________________Parent/Guardian Signature (if under 18):____________________________________School Building Location:__________________________________Grade of Student:________________________Telephone Number of Parent/Guardian:____________________Parent Notification of Repair RequestE-Mail: __________________________________