Assistive Technology Classroom Inventory

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Please submit this form for each student who has assistive technology checked out. If you have assistive technology in your classroom, but do not know who it belongs to, please return it to MCISD's Instructional Resource and Technology Center (IRTC) at the completion of the school year.

Staff Member's Last Name *

Staff Member's First Name *

Staff Member's Email Address *

School District *

What school/teacher will the student have for the 2023-2024 school year? *

Assistive Technology Number (AT#)/Asset Tag Number/Serial Number *

Description of Item (e.g., iPad, switch, software, etc.) *

Student Last Name *

Student First Name *

Does the student require the assistive technology over the summer? *

Yes

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