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ComputerLoanAgreementForm(RoseHillHighSchool-USD394
Computer Loan Agreement Form
(Rose Hill High School Students Only)
Date: Grade:
Student’s Name: Home Phone:
A district laptop is being loaned to the Borrower for academic purposes. It is my responsibility to care for the equipment and
ensure it is maintained in a safe environment . A $60.00 fee is assessed to cover the cost of the insurance premium and will
not reduce any fee associated with an insurance deductible. This insurance covers the laptop if it is stolen or accidentally
damaged. If there is an insurance claim on the laptop, the student and/or parent are responsible for up to a $100 deductible
per incident. If the computer is lost, stolen or damaged, parents/guardians/students should immediately file a report with the
high school administration .
The laptop computer, computer charger brick, charger cord and carrying case are the property of Rose Hill USD
394, Rose Hill, KS and is herewith being loaned to the student for educational purposes only for the academic
school year. Students may not deface or destroy this property in any way. Inappropriate material on the machine
may result in the student losing their right to use this computer. The equipment will be returned to the school on a
date to be requested or sooner if the student is discharged from school prior to the end of the school year. Students
who do not return the computer and related materials when requested may be subject to criminal prosecution or civil
liability. A late fee may be charged if the laptop is not returned to the school district on the required check-in date.
If the laptop equipment is lost, stolen or damaged while in the Borrower’s possession, Borrower is responsible for
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