Forms

The following forms are from the Charlottesville City Schools Acceptable Use Policy for Technology 10.

**DECLARATION OF UNDERSTANDING AND ADHERENCE (** **Students under 18** **)**

I, the parent or guardian of _ (student’s name), the minor student who has signed, along with me, this acceptable use policy, understand that my son or daughter must adhere to the terms of the District's Acceptable Use Policy for Technology. I understand that access to technology resources is for educational purposes only. I accept responsibility to set and convey standards for appropriate and acceptable use to my son or daughter when he or she is using technology resources.

Date:

Parent or Guardian Name (Please Print): Parent or Guardian Signature:

Student Name (Please Print): Student Signature:

Homeroom Teacher:

**DECLARATION OF UNDERSTANDING AND ADHERENCE (** **Students over 18, Parents, Community Members** **)**

I understand that I must adhere to the terms of the District's Acceptable Use Policy for Technology. I understand that access to technology resources is for educational purposes only. I accept responsibility to follow standards for appropriate and acceptable use when I am using technology resources.

Date:

Student Name (Please Print): Student Signature:

School: Grade:

Homeroom Teacher:

**DECLARATION OF UNDERSTANDING AND ADHERENCE (** **District Employees** **)**

I understand that I must adhere to the terms of the District's Acceptable Use Policy for Technology. I understand that access to technology resources is designed for educational purposes. I accept responsibility to follow standards for appropriate and acceptable use when I am using technology resources.

Date:

Name (Please Print): Signature:

School, Department, or Program: