Student Technology Usage Agreement

4^th – 12^th Grades

I have read the Gasconade County R-II School District’s Internet Usage Policy 6320 and Regulation 6320 and agree to comply with all their provisions and will communicate over the internet in a responsible fashion while honoring all relevant laws and restrictions.

Student Signature _____________________________________________Date __________________

Parent Technology Usage Agreement

As the parent or legal guardian of the minor student signing above, I certify that I have read the Gasconade County R-II School District’s Policy 6320 and Regulation 6320 on Internet Usage, and I hereby grant my son/daughter permission to access the internet. I understand that violation of these provisions may result in disciplinary action against my son/daughter as outlined under Consequences of page 4 Regulation 6320. I understand that individuals and families may be held liable for violations. I understand that some materials on the internet may be objectionable, but I accept responsibility for guidance of internet use, setting and conveying standards for my son/daughter to follow when selecting, sharing, or exploring information and media.

Parent Signature _______________________________________________Date__________________

Name of Student ____________________________________________________________________

Please Print

Home Address ______________________________________________________________________

__________________________________________________________________________________

Home Telephone ____________________________________________________________________

SIGNED FORM MUST BE RETURNED TO SCHOOL BEFORE STUDENT WILL BE ALLOWED INTERNET ACCESS.