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Item amount: 
$____
2024-2025 Technology Insurance
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TECHNOLOGY INSURANCE PAYMENTS CAN BE ACCEPTED BEGINNING JULY 1, 2024.

Please use this form if you are opting to purchase the 2024-2025 technology insurance for student chromebooks. 

The pricing structure is as follows, please select one.

  • Individual student ($30 per student)
  • Individual student  Free/Reduced Lunch Eligible ($10 per student)
  •  

If you have multiple students in your household, please fill out the form for the first student and add it to your cart. Next, fill out another form and add it to your cart. Please repeat for each additional student in your household. 

Please note, we will be verifying the free/reduced status so you will need to complete the free/reduced lunch application.  If you select either of these options and are found to be ineligible, we will contact you for additional information. 

Payment to: Midland Public Schools
Item Amount: $____
+ Additional Fees:
Convenience Fee $0.00
Item Total $____

Amount:


The amount must be between $10.00 and $30.00.

Additional Information Requested

Please enter first and last name of student
Please select the option that you would like to purchase.
Please enter first and last name of guardian
Please only use if you have selected the "Family Maximum" option!
Please only use if you have selected the "Family Maximum" option!
Please only use if you have selected the "Family Maximum" option!
Please only use if you have selected the "Family Maximum" option!
Please only use if you have selected the "Family Maximum" option!
Please only use if you have selected the "Family Maximum" option!