Updated 7/15/13

The Lovett Lower School

Technology Misuse Form

TEACHER COMPLETE

Student _____________________________ Grade __________ Teacher _________________ Date ____________

The student violated The Lovett Schools Technology Rules of the Road policy in the following manner:
Violation

Teacher Comment

Left laptop unattended

Accessed inappropriate material
Physically damaged a device
Left device or charger at home
Returned laptop uncharged
Changed configuration of school device
Used school device inappropriately
Other

STUDENT COMPLETE
Please refer to the Rules of the Road contract you signed. In the space below, write a paragraph including:
$ the infraction and how you earned it
$ what choice(s) you should have made regarding appropriate care and use of the technology
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Student Signature___________________________________________________ Date ___________________

TEACHER COMPLETE
Infraction #: ________
Consequence:
_____ Hold for ____ day(s)

PARENT SIGNATURE

_____ Conference with student

_____ Other _________________________

DATE