Electronic Access/user Agreement Forms Aup Form For Students - Montgomery County School District'S
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1CURRICULUM AND INSTRUCTION
08.2323 AP.21
Electronic Access/User Agreement Forms
AUP F
S
ORM FOR
TUDENTS
S
’
N
(
) __________________ (
) __________________ (
) _____
TUDENT
S
AME
LAST
FIRST
INITIAL
S
’
A
____________________________________________________________
TUDENT
S
DDRESS
S
’
A
____ D
B
__________ S
___ P
N
_____________
TUDENT
S
GE
ATE OF
IRTH
EX
HONE
UMBER
S
______________________________________________________________________
CHOOL
G
_______ H
/C
______________________
RADE
OMEROOM
LASSROOM
As a user of the Montgomery County School District’s computer network, I hereby agree to comply with the
District’s Internet and electronic mail rules and to communicate over the network in a responsible manner while
abiding by all relevant laws and restrictions. I further understand that violation of the regulations is unethical
and may constitute a criminal offense. Should I commit any violation, my access privileges may be revoked and
school disciplinary action and/or legal action may be taken.
Student’s Signature ______________________________________________ Date _________________
Prior to the student’s being granted independent access privileges, the following section must be
completed for students under 18 years of age:
As the parent or legal guardian of the student (under 18) signing above, I grant permission for my child to access
networked computer services such as electronic mail and the Internet. I understand that this access is designed
for educational purposes; however, I also recognize that some materials on the Internet may be objectionable,
and I accept responsibility for guidance of Internet use by setting and conveying standards for my child to
follow when selecting, sharing, researching, or exploring electronic information and media.
C
U
ONSENT FOR
SE
By signing this form, you hereby accept and agree that your child’s rights to use the electronic resources
provided by the District and/or the Kentucky Department of Education (KDE) are subject to the terms and
conditions set forth in District policy/procedure. Please also be advised that data stored in relation to such
services is managed by the District pursuant to policy 08.2323 and accompanying procedures. You also
understand that the e-mail address provided to your child can also be used to access other electronic services or
technologies that may or may not be sponsored by the District, which provide features such as online storage,
online communications and collaborations, and instant messaging. Use of those services is subject to either
standard consumer terms of use or a standard consent model. Data stored in those systems, where applicable,
may be managed pursuant to the agreement between KDE and designated service providers or between the end
user and the service provider. Before your child can use online services, he/she must accept the service
agreement and, in certain cases, obtain your consent.
Name of Parent/Guardian (Please print) ____________________________________________________
Signature of Parent/Guardian ___________________________________________________________
S
:
Return this form to your school.
TUDENTS
Review/Revised:4/26/2016
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