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Charles Drew iPad Request
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* Indicates required question
Student First Name / Nombre del estudiante
*
Your answer
Student Last Name / Apellido del estudiante
*
Your answer
Student Date of Birth / Fecha de nacimiento del estudiante
*
MM
/
DD
/
YYYY
LAUSD District ID / ID del Distrito del LAUSD
Your answer
Single Sign On (lausd email address) / Inicio de sesión único (dirección de correo electrónico lausd)
Your answer
Current Grade Level / Nivel de grado actual
*
7th Grade
8th Grade
Required
Homeroom Teacher / Profesor de aula
Your answer
Parent Name / Nombre del padre
*
Your answer
Parent Phone Number / Número de teléfono de los padres
*
Your answer
Home Address / Direccion de casa
*
Your answer
iPad Number (To be provided at distributtion) / Nombre de iPad (Para ser proporcionado en la distribución)
Your answer
Do you have internet access / tiene acesso al internet
*
Yes / Si
No
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