Name:_________________________ Date:__________
Technology Serial #______________________________
Equipment Description and Serial #______________________________
I hereby certify that I have received, read, understand and agree to all of the terms and conditions in the Columbus Community School District’s Appropriate Use of Technology, Network Systems, and Internet Access policy.
I understand that the technology and related equipment I am being issued is the property of the Columbus Community School District. I will return the technology and any related equipment I am issued in the same condition in which receive it, excluding normal wear and tear and unforeseen system breakdowns. I understand that I am responsible for any damage or loss of any component of the technology and/or related equipment I am issued. In case of damage or loss, I agree that I will replace any damaged or lost component and/or equipment with components and/or equipment of equal value and functionality as approved by the District’s administration.
I accept full responsibility for my use of the District’s technology, network systems, and internet access in accordance with the terms, conditions, and guidelines as stated by the District in its policies and regulations and as set out in federal and state law. I understand that violation of these provisions will result in the restriction and/or termination of my ability to use the District’s technology, network systems, and internet access and may result in further discipline up to and including termination of my employment with the District and/or other legal action.
I will not hold the District responsible in any way for materials accessed through the District’s technology, network systems, and/or internet access. I relieve the Columbus Community School District and its officers and employees from any and all financial responsibility that may be incurred by my use of the District’s technology, network systems, and internet access.
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Signature
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Printed Name
_________________________________
Date
Approved: 10/16/14
Reviewed: FY 2016-2017, August 15, 2016, June 28, 2021
Revised: 02/24/17