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Technological Equipment Acknowledgement -Form Fill

Section One
Q1

Student Name

First Name
Q2

Student Name

Last Name
Q3

Address

Street Address
Q4

Address

Street Address Line 2
Q5

Address

City
Q6

Address

State / Province
Q7

Address

Postal / Zip Code
Q8

Date of birth

Date
Q9

Class Name
Q10

Modal of iPad
Q11

Did you receive Charging Cable?
Q12

Did you receive Charging Brick?
Q13

Did you receive iPad Case?