Loan Agreement (English)

Madison Public Schools

MACCESS Laptop Loan Agreement

2009-10 School Year


This Agreement represents an outline of the Acceptable Use Agreement. By signing this Agreement, students and parents/guardians agree to follow the Acceptable Use Agreement. 


1.    I agree to abide by the Acceptable Use Agreement.

2.    I agree that my use of District technology resources is for educational purposes only.

3.    I agree that my use of District technology resources is a privilege and that I am responsible for the proper care of the computer that is assigned to me, as well as any other District technology resources I am allowed to use.

4.    I agree to keep all accounts & passwords assigned to me secure & will not share these with any other students. This includes passwords for email & network access.

5.    I agree that I will never share personal information over the Internet. In addition, if I am asked for personal information or harassed in any way I agree to report it immediately to my parents and the MACCESS Core Team.

6.    I agree that I will not install, download, or otherwise utilize any software that is not authorized by the MACCESS Core Team.

7.    I understand that if I do not abide by the Acceptable Use Agreement I am subject to disciplinary consequences as outlined in the Acceptable Use Agreement and the Student Handbook. In addition, I may be subject to legal action if my actions break the law.

8.    I will comply with all copyright laws.


Damage/Loss Coinsurance and Liability

Please read the information below to determine if the coinsurance program offered by the Madison Public Schools is needed for you and your student’s protection against damage and/or loss of the district technology resources loaned to you. This form must be completed & marked Yes or No, and the applicable fee paid, before the computer will be loaned to the student.


Coverage & Benefit

Submitting the requested fee of $25 provides a $100 maximum deductible for accidental damage, and covers the computer loaned to the student against all damage or loss over $100. Accessories valued at less than $100 are not covered. Coverage is 24 hours a day. Total value will be determined at the time of loss or damage. In no case shall the value be greater than $1,100.  Damages determined to be intentional are not covered by this coinsurance provision.


Effective & Expiration Dates

This coverage is effective from the date this request form and coinsurance premium payment are received by the school through the date when the computer is returned in good working order to the school.



The total coinsurance premium cost is $25 per school year. This fee is not refundable.


It is agreed & understood that 1) Madison Public Schools will offer coverage to all students, 2) coverage is voluntary, and 3) a separate application will be needed for each computer covered.


_____    Yes, I will participate in the damage/loss coinsurance offered by Madison Public Schools.

            _____ Cash              _____ Check (#_____ )


_____    No, I decline to participate in the damage/loss coinsurance plan offered by the Madison Public Schools. I understand that I am responsible for 100% of any damage or loss to the loaned computer.


My signature and that of my parent or guardian, acknowledges receipt of and agreement to abide by the terms of the Acceptable Use Agreement while using the school issued laptop. 



______________________________            __________                ______________________________            __________

student                                                 date                              parent/guardian                                                date