Participation in an Electronic Communication System

Employee Agreement Form

Petrolia Independent School District

I have read the Petrolia ISD “Electronic Communications and Data Management Policy” and agree to abide by their provisions.  In consideration for the privilege of using the Petrolia ISD electronic communications system and in consideration for having access to the public networks, I hereby release the Petrolia ISD, its operators, and any institution with which they are affiliated from any and all claims and damages of any nature arising from my use of, or inability to use the system, including, without limitation, the type of damages identified in the Petrolia ISD policy and administrative regulations.

Name  _____________________________________________________

                        (First, Middle Initial, Last)

School:   High School               Junior High                   Elementary     (Circle one)

Signature ___________________________________    Date  __________________

This space reserved for district technology coordinator.

Assigned username __________________________

Assigned password __________________________  (Password is to be changed every semester)

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