3520.13 Form

_____________________ PUBLIC SCHOOLS

_____________________, Connecticut

STAFF REQUEST FOR APPROVAL OF TECHNOLOGY RESOURCES

Before use in the classroom, use with students, or administrative use, all online learning resources, online applications, digital subscription services, and other programs or technology applications requiring the user to accept terms of services or a user agreement must be approved by the ______________________ (Technology Coordinator/Principal)

To request to use such an online resource or technology application other than a District-approved resource, please complete and submit the following form.

Name: ____________________________________________________________________________________________

Position:  ____________________________________________________________________________ (example: teacher)

Date: _____________________________________________________

If the resource will be used by students, which grade(s)?:_______________________________________________________

1.  Give name and description of the technology resource you are requesting to use. If you are requesting an online resource, please include a link to the resource.

2.  Describe how you plan to use the requested resource. What information, if any, will be shared? Who will have access to the resource? If for use by students, will students need to sign up for an account or download an application? Is parental permission required by the application before use by a student?

For Office Use Only

_______ Approved for use

_____Additional parental notification and permission required.

_____No additional notifications or permissions required.

_______Not approved for use at this time

_______Reason: