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I.T. Request Form

I.T. Request Form

Full Name(s) of Learner(s)* Year Group(s) / Form Group(s) of Learner(s)* Learner(s) Date of Birth(s) (DD/MM/YYYY)* Address (Street Name & House Number)* Postcode* Parent / Carer Email Address* Please give details on the reason you would like to loan a device (eg. no suitable device at home, viewing content on phone)* Do you have WiFi access at home? (Please note if the answer is 'no' then we may not be able to provide a device)*

I agree to follow the terms & conditions of any loaned device from Pegasus Academy*YesNo

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I.T. Request Form

Address
Pegasus Academy Scotts Green Close Dudley DY1 2DU
Telephone
01384 253722
Email
office@pegasusacademy.org.uk

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