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Student Chromebook Assistance Form
Please fill out the following information. A representative from the technology department will contact you as soon as possible.
For Spanish, click here:
bit.ly/brushchromebookspanish
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* Indicates required question
Parent Full Name
*
Your answer
Student Full Name
*
Your answer
Contact Email Address
*
Your answer
Contact Phone number
*
Your answer
I am a:
*
Student
Parent/Guardian
Other:
Student Grade
*
Choose
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
I need assistance with:
*
Please Check all that apply
Wifi Issues
Won't Turn On
Password reset
Student Portal (Clever)
Chromebook Damaged
Other
Required
Best Available Time
If there is a preferred time you would like us to contact you, please enter it here. Otherwise the technician will contact you as soon as possible.
Your answer
Notes
Please type any details you would like us to know.
Your answer
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This form was created inside of Brush School District RE2(J).
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