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Department of Technology Services Denver Public Schools




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Denver Public Schools
Student Internet Authorization


To be completed by the parent or legal guardian for students under the age of 18.

As the parent or guardian of a DPS student I have read Policy EGAEB, Internet Policy, understand its contents, and agree that my child will abide by it. I am fully aware that this system is administered by the school district and is intended for official school district business and educational use only.

Should my child commit any violation of Policy EGAEB, his/her access privileges may be revoked, and other disciplinary action may be taken.

I hereby give permission to issue Internet access for my child and certify that the information contained on this form is correct.

_________________________________________________________________
Student Name (please print)

________________________________________________________________
Parent or Guardian's Name (please print)

______________________________________________ Date:____/____/____
Parent or Guardian's Signature

Return this form to your child's school.