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Middletown Area School DistrictMiddletown Area School District55 West Water Street – Middletown, PA 17057
Middletown Area School DistrictMiddletown Area School DistrictAcceptable Use Policy for TechnologyAcceptable Use Policy for Technology
User Access Request Form
NOTE: THIS INFORMATION WILL NOT NEED TO BE SUBMITTEDON AN ANNUAL BASIS, UNLESS PARENT/GUARDIAN/DISTRICT
REQUESTS TO CHANGE THE CONTENT/SELECTIONS MADE THE PREVIOUS YEAR.
For This Form To Be Honored,ALL Asterisked(* Information Must Be Provided!!
CLEARLY PRINT OR TYPE THE FOLLOWING INFORMATION (except for signatures)
Name*: _________________________ Building: __________ *___Student/ __Employee/ ___Parent
Home Email Address: _____________________________________________________________
Home Computer (Make, Model): _____________________________________________________
I have read the District’s Acceptable Use Policy for Technology.I agree to follow the rules contained in this policy.
I understand that violation of these rules, may result indisciplinary, and possibly, legal action.
User’s Signature*: ___________________________________________________ ___/___/______
CONTINUE FOR STUDENT ACCESS:
Homeroom Teacher: ___________________________ Graduation Year*: ________________
Social Security Number*: _________ - _______ - ___________ Birthdate: ____/____/_______
PLEASE, MAKE ONE SELECTION*: (Check Only One)
___ I give permission for my child to use the school computers and to access the Internet,with supervision.
___ I give permission for my child to use the computers in the school environment,but he/she may not access the Internet or participate in any online activities.
___ My child may not use any computer within the school environment.
Print Parent/Guardian’s Name*: _________________________________________ ___/___/______
Parent/Guardian’s Signature*: __________________________________________ ___/___/______
Home Address: _________________________________________ Telephone: _________________
System Administrator Section, Only!User ID: ___________________________ Special Access Code: _________________________
Temporary Password: _____________________
Level of Account (User Profile Types): __ N/A, __ A, __ B, __ C, __ D, __ E, __ F, __ G
COMMENTS: __________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Updated: 8/1/02
https//powerschool.raiderweb.org/public
1. Notice this is a secure website, requiring a special login and password.
2. Do not type “http” or “www”
3. Once this screen displays, bookmark this page, to speed-up your next visit
Parent User IDParent User ID
UsernameUsername = “p” + “Student Grad Yr” + “Student FInitial LName” p04jdoep04jdoe
PasswordPassword = 3 Letters + 4 Numbers blw9427blw9427
NOTE: Accounts are different for each child, so that they may be shared with the student, if desired.
Close the program window or…
Input Parent User IDInput Parent User ID
for another child.
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