TEACHER APPLICATION

I have read the Terms and Conditions of Internet Access at East Middle School. I understand and will abide by these stated Terms and Conditions. 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/or appropriate legal action taken. I also agree to promote and encourage student compliance with this agreement, instruct students on acceptable use of the network and proper network etiquette, and to take appropriate steps when inappropriate use of the Internet and/or the network comes to my attention.

Teacher's name (please print)_______________________________________

Teacher's signature _____________________________________

Date _____/_____/_____

Grade level _________ Subject taught (if an exploratory teacher) _____________________

Signature of Internet instructor/sponsoring teacher _________________________________

Date of on-line Internet training _____/____/_____

**Once completed, please give it to your media specialist or a technology trainer.