Fine

and Performing Arts Academy

Technology Equipment Request Form
(Please fill out completely and return to Ms. Cruzs Mailbox)


Equipment/Items available for check out: SMART Boards, computer cart (20 per cart), iPad cart ( 20 per cart) and Sony
Digital Camera.

In order to ensure equitable access to technology equipment, please adhere to the following guidelines: please
submit your request no less than 3 SCHOOL DAYS before the date of expected use. All equipment is available for check out on a
block by block basis. If you require it for more than 1 block, be advised that availability is dependent on requests for usage by
other teachers. It is your responsibility to pick up and return all equipment by the date/block indicated.

Date:_________________
Staff Name:________________________________ Room #:________________
Email:______________________________
Date equipment is needed: _________________ Block# :__________________
Equipment requested (One form must be submitted per item requested) _____________________________________________

Laptop/iPad Cart Policy:

It is the responsibility of the teacher to pick up/return the laptop cart from the Technology Coordinator. A count
of all equipment needs to be done, so the best time to do this is during non-instructional time.
It is the responsibility of the teacher to make certain that the battery charging process is started and that all
laptop carts are connected to power outlet when in use.
Please be sure to leave laptop cart neat and orderly for the next user.
All maintenance issues must be recorded in the maintenance log (located inside cart)
Be responsible for care and use of laptops in your classroom. No drinks or food are to be consumed around
any computer equipment.
Supervise and guide students in proper care and use of the laptops. NO student is to use a laptop if they
cannot provide you their ID. Hold on to their ID until you get the laptop returned to you.

Other Technology Policy:

It is the responsibility of the teacher to pick up/return all equipment from the Technology Coordinator before
and after each use.
All maintenance issues must be recorded in the maintenance log (provided at time of check out)

-------------------------------------------- To Be Filled Out During Check-in/Check-out ONLY------------------------------------

Date

Item/Equipment

Check Out Qty.

Check In Qty.

Date/Block Due

Teachers Signature

Tech. Coordinator Signature

Notes:______________________________________________________________________________________________________________
______________________________________________________________________________________________________________________

Fine and Performing Arts Academy

Technology Support Request Form
(Please fill out completely and return to Ms. Cruzs Mailbox)

Date:_________________
Staff Name:________________________________

Room #:________________ Conference Period(s)____________

Email:______________________________
Specific Equipment Requiring Service:
Brand_________________ Model_______________ Serial number (reqd to check warranty)_________________

Describe Problem (be specific):_______________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________


Recommendation/Next Steps:

Please call ITD Service Desk at (213) 241-5200 to request support and/or open a Service Ticket online
at http://askitd.net/helpdesk

Please call ITD Service at (213) 241-5200 to have item picked up directly from you for repairs (item is
still under warranty).

Please return item to my room (3206) so that I may address issue before or after school. Please allow 3
days for service to be completed.

I will stop by your classroom on ______________________ at/during ______________________.


Please Note:

Basic Support Provided by Technology Coordinator includes set-up and troubleshoot FPA classroom/FPA Office consoles (computer hardware, projector, document
camera, laptop/computer connections, iPad and AppleTV). Software issues need to be directed to the company that carries the product given we do not have on hand
many of the original programs installed in your computer (i.e. GradebookPro, Office, etc). Currently, there is no specific period designated for Technology Services, so
every effort will be made to respond in a timely manner. Your patience is greatly appreciated.

------------------------------------------DO NOT WRITE BELOW THIS LINE---------------------------------------

Date Issue Addressed:____________________________ Staff Signature:__________________________________
Follow up notes: _______________________________________________________________________________________
___________________________________________________________________________________________________________

Laptop Maintenance Log for Cart #_____________

Please report any issues with specific laptops here. Make sure to identify the laptop so we know exactly
which one needs to be serviced.

Laptop/iPad # Describe Issue

Ex. #4

Will not turn on

 Student Laptop Assignment for Cart #_____________

Teachers Name:_________________________

You must collect a Student ID from any student to whom you issue a laptop. Hold on to the ID until student
returns laptop to you.

Laptop # Students Name

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Laptop/iPad Cart Policy:

1. It is the responsibility of the teacher to pick up/return the
laptop cart from the Technology Coordinator. A count of all
equipment needs to be done, so the best time to do this is
during non-instructional time.
2. It is the responsibility of the teacher to make certain that
the battery charging process is started and that all laptop
carts are connected to power outlet when in use.
3. Please be sure to leave laptop cart neat and orderly for the
next user.
4. All maintenance issues must be recorded in the
maintenance log (located inside cart)
5. Be responsible for care and use of laptops in your
classroom. No drinks or food are to be consumed around
any computer equipment.
6. Supervise and guide students in proper care and use of the
laptops. NO student is to use a laptop if they cannot provide
you their ID. Hold on to their ID until you get the laptop
returned to you.