Internet Usage Permission Form



Student Name (please print)



Student I.D. Number


Dear Parent or Guardian:

With your permission your young adult will be able to access the Internet at school as part of their class instruction. Below are the rules for use at the school. Please read before you consider granting permission.


Guidelines for Internet Usage

    1. All students must have a signed permission slip from their parents that authorizes them access to the Internet.
    2. Respect for the equipment of the school and its network is a condition for use of the computers.
    3. Students are to notify the teacher/librarian immediately of any disturbing material they may encounter on the web or in e-mail.
    4. Students are not to give out personal information like telephone number, full name, address, etc. to anyone on the Internet.
    5. Students are to never give anyone their password to any of their accounts or allow another student to use their account to access the Internet or school network.
    6. Students must gain clearance from the teacher/librarian before downloading any programs from the Internet.
    7. All floppies brought to the lab or library to be used in the computers must first be scanned for viruses by the teacher/librarian.


Violation of any of these rules may result in forfeiture of permission to use the Internet and school network and/or appropriate disciplinary action. Please sign below if granting permission and have the entire form returned. DO NOT tear off the bott om



I ____________________________ give permission for my young adult to access the

(Parent sign here)

Internet and publish class-related information on it in accordance with the above guidelines.

_________ Date

I ___________________________ have also read the above and will honor the Guidelines

(Student sign here)

for Internet Usage at Murry Bergtraum High School


_________ Date