Sambourne C of E VC Primary School
- Survey
Loan device for working from home
Please complete this form if you would like to loan a device for your child to use at home should they either be self-isolating or in the event of a school closure. You will need to complete one form per child.
Q1. Do you wish to have a loan device for your child to use at home?
Yes
No
Q2. Please tell us you child's full name.
Q3. Please confirm your name (not child's)
Q4. Please confirm your mobile telephone number
Q5. Please confirm your email address
Q6. Do you have access to home broadband via wifi?
Yes
No
Q7. Do you commit to taking full responsibility for the device and agreeing to pay for any theft, loss or damage?
Yes
No
Q8. Is your child already at home due to self-isolation?
Yes
No
Q9. Are you able to collect the device and sign it out?
Yes
No
Q10. If the answer to Q9 is no, can you let us know who will ask to collect the device on your behalf. They will need to sign for the device on collection.
Submit