DN-R2 Attachment

Published by jackbgarvey on Mon, 07/29/2013 - 15:04

Little Rock School District

Parent Agreement for Computer Salvage Loan Program

 (Computers for Kids)


School Name ______________________________________________


Parent Section

I agree to the following:

  • My child does not have access to computer technology in my home.
  • My child needs access to computer technology for educational purposes.
  • I will provide a surge protector for this computer.
  • I will be responsible for maintenance of the computer if loaned and am responsible for the return of the computer at the end of the school year for which a computer is loaned.
  •  I will be responsible for any damage to the computer, and am responsible for the cost for recovery of this computer and the cost of any damages.
  • The District has a right to sell any loaned computer at its fair market value.
  • I have the option to purchase this computer at the fair market value.  Under this option, the District has no responsibility for this equipment and the parent accepts the computer and accessories “as is”. 


Parent signature_____________________________________    Date _______


Student signature____________________________________    Date  _______



Little Rock School District Section              School Site:  ___________________


Certification of Need by School Staff   

By signing this document, I attest to this student’s need for access to a personal computer.


Teacher signature_____________________________________    Date _____


Administrator signature________________________________      Date _____


Computer Inventory Tag  _________  Model # _________  Serial #_________


Fair Market Value for Model  _______   


Sold Date_______    ******Loaned Date_________ Date of Return___________