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City School District

Online Student Tool Request Form

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Online Student Tool Request Form (including Chrome Apps & Extensions)
Please answer the following questions about the online tool you wish to create student accounts for.


Teacher Name
Have you contacted your building principal regarding this tool? Please list date contacted and any further information.
Name of website, including URL (please be specific)
Is the student tool a Chromebook app or extension that will need added to the allowed apps and extensions for students?
Who will use this site?

What information does the tool require from the student to create their account?

Check all that apply.

If you answered "other" to the question above, please list the other information required by the student to create their account:
What does this tool enable you to do?
How will students use this tool to integrate technology?

What are some instructional objectives this tool will help students accomplish?
Has this vendor signed the student privacy pledge?
Click here to view the list of signatories.
Your Name:
Your Email:
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To validate your submission, please type the answer to the question.