Author: EISD

BYOT
Bring Your Own Technology
Application

1. My Name:
________________________________________________________________
2. My Homeroom Teacher:
_________________________________________________________________
3. The Technology or Device I would like to use:
__________________________________________________________________
__________________________________________________________________
4. What I plan on using this device for: (you can write on the back if you need more space)
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5. My Parents and I have read and signed the attached User Guidelines.
_____yes
_____no

Grade level teachers:
We approve, do not approve, this application: Circle one and each grade level teacher sign.
Submit to Mrs. Couvillion for final confirmation.
Mrs. Couvillion’s signature:

Please keep this form and the BYOT User agreement signed by the student and parent on file.