HPS Device Waiver Fee

HPS Device Waiver Fee

This form is only required if you are looking to pay for the fee via credit card/digital wallet. If you would like to pay via cash or check, please visit your child(ren)'s school(s).
Please submit a single form per child.

As part of the District's 1:1 initiative where every Haverhill Public Schools student receives an HPS-issued Chromebook, you have the opportunity to protect the device for this school year by paying a Device Waiver Fee. As outlined in the HPS Student Technology Device Policy, this $20 fee will help to cover the costs of potential damage, repair, or loss for the school year for your student's assigned device. Please note: issues of theft should still be reported to the police.

If the annual optional Damage Waiver Fee is not purchased, the typical cost of repairing components is as follows, where an invoice could be sent to the family:
- Charger - $39
- LCD Screen - $80
- Top/Bottom Cover - $30-35
- Keyboard - $70
- Trackpad - $10
- Device Replacement (when damage to the device is unrepairable) - $199
Parent / Guardian Information
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Student Information
Student's Name*

First NameLast Name
Student's School*

Bradford Elementary SchoolBartlett School and Assessment CenterConsentino SchoolGateway AcademyGolden Hill Elementary SchoolGreenleaf AcademyHaverhill High SchoolHunking SchoolMoody Elementary SchoolNettle Middle SchoolPentucket Lake Elementary SchoolSilver Hill Elementary SchoolTilton Elementary SchoolJG Whittier Middle SchoolWalnut Square Elementary SchoolOther
Student's Grade*
Device Information

The Asset ID is a 6-digit number on the sticker at the bottom of the Device. The Serial Number can be found in the Device's Settings.
Asset ID or Serial Number*