Portage Township Schools ADP Enrollment Form – Payment Plan

This form should only be completed if approved by Portage Township Schools for your family to purchase ADP coverage on a payment plan.

- Step 1 of 3

Parent / Guardian Name: *

First

Last

Email *

Phone

Number of Students Being Registered: *

Student #1 ----------------------------------------------------------------------------------------------------------------------

Fill out the information below to register your student.

Student #1

Student Name *

First

Last

Student Grade *

Student ID Number *

No Coverage Needed at This Time.

Portage Township students grades K-5 do not need to purchase covarage at this time.

If you have additional student in grades 6-12, please continue to submit your registration.

If you have no students in 6-12th grade, you may exit the form without submitting.

If you have any questions please contact the Secured Tech Solutions Customer Care Team at 1-833-STS-1to1 or customercare@securedtechsolutions.com

Accidental Damage Protection Plan Options (6th-8th) *

Accidental Damage Protection Plan Options (Freshman) *

Accidental Damage Protection Plan Options (Sophomore) *

Accidental Damage Protection Plan Options (Junior) *

Accidental Damage Protection Plan Options (Senior) *

*Cost covers case ONLY.

Any repairs required due to accidental damage will be an additional cost to the parent/guardian.

To see the repair cost estimates click here.

Student #2 ----------------------------------------------------------------------------------------------------------------------

Fill out the information below to register your 2nd student.

Student #2

Student #2 Name *

First

Last

Student #2 Grade *

Student #2 ID Number *

No Coverage Needed at This Time.

Portage Township students grades K-5 do not need to purchase covarage at this time.

If you have additional student in grades 6-12, please continue to submit your registration.

If you have no students in 6-12th grade, you may exit the form without submitting.

If you have any questions please contact the Secured Tech Solutions Customer Care Team at 1-833-STS-1to1 or customercare@securedtechsolutions.com

Accidental Damage Protection Plan Options (6th-8th) #2 *

Accidental Damage Protection Plan Options (Freshman) #2 *

Accidental Damage Protection Plan Options (Sophomore) #2 *

Accidental Damage Protection Plan Options (Junior) #2 *

Accidental Damage Protection Plan Options (Senior) #2 *

*Cost covers case ONLY.

Any repairs required due to accidental damage will be an additional cost to the parent/guardian.

To see the repair cost estimates click here.

Student #3 ----------------------------------------------------------------------------------------------------------------------

Fill out the information below to register your 3rd student.

Student #3

Student #3 Name *

First

Last

Student #3 Grade *

Student #3 ID Number *

No Coverage Needed at This Time.

Portage Township students grades K-5 do not need to purchase covarage at this time.

If you have additional student in grades 6-12, please continue to submit your registration.

If you have no students in 6-12th grade, you may exit the form without submitting.

If you have any questions please contact the Secured Tech Solutions Customer Care Team at 1-833-STS-1to1 or customercare@securedtechsolutions.com

Accidental Damage Protection Plan Options (6th-8th) #3 *

Accidental Damage Protection Plan Options (Freshman) #3 *

Accidental Damage Protection Plan Options (Sophomore) #3 *

Accidental Damage Protection Plan Options (Junior) #3 *

Accidental Damage Protection Plan Options (Senior) #3 *

*Cost covers case ONLY.

Any repairs required due to accidental damage will be an additional cost to the parent/guardian.

To see the repair cost estimates click here.

Student #4 ----------------------------------------------------------------------------------------------------------------------

Fill out the information below to register your 4th student.

Student #4

Student #4 Name *

First

Last

Student #4 Grade *

Student #4 ID Number *

No Coverage Needed at This Time.

Portage Township students grades K-5 do not need to purchase covarage at this time.

If you have additional student in grades 6-12, hit the next button to continue registration.

If you no students in 6-12th grade, you may exit the form without submitting.

If you have any questions please contact: the Secured Tech Solutions Customer Care Team at 1-833-STS-1to1 or customercare@securedtechsolutions.com

Accidental Damage Protection Plan Options (6th-8th) #4 *

Accidental Damage Protection Plan Options (Freshman) #4 *

Accidental Damage Protection Plan Options (Sophomore) #4 *

Accidental Damage Protection Plan Options (Junior) #4 *

Accidental Damage Protection Plan Options (Senior) #4 *

*Cost covers case ONLY.

Any repairs required due to accidental damage will be an additional cost to the parent/guardian.

To see the repair cost estimates click here.

Student #5 ----------------------------------------------------------------------------------------------------------------------

Fill out the information below to register your 6th student.

Student #5

Student #5 Name *

First

Last

Student #5 Grade *

Student #5 ID Number *

No Coverage Needed at This Time.

Portage Township students grades K-5 do not need to purchase covarage at this time.

If you have additional student in grades 6-12, please continue to submit your registration.

If you have no students in 6-12th grade, you may exit the form without submitting.

If you have any questions please contact the Secured Tech Solutions Customer Care Team at 1-833-STS-1to1 or customercare@securedtechsolutions.com

Accidental Damage Protection Plan Options (6th-8th) #5 *

Accidental Damage Protection Plan Options (Freshman) #5 *

Accidental Damage Protection Plan Options (Sophomore) #5 *

Accidental Damage Protection Plan Options (Junior) #5 *

Accidental Damage Protection Plan Options (Senior) #5 *

*Cost covers case ONLY.

Any repairs required due to accidental damage will be an additional cost to the parent/guardian.

To see the repair cost estimates click here.

Student #6 ----------------------------------------------------------------------------------------------------------------------

Fill out the information below to register your 6th student.

Student #6

Student #6 Name *

First

Last

Student #6 Grade *

Student #6 ID Number *

No Coverage Needed at This Time.

Portage Township students grades K-5 do not need to purchase covarage at this time.

If you have additional student in grades 6-12, please continue to submit your registration.

If you have no students in 6-12th grade, you may exit the form without submitting.

If you have any questions please contact the Secured Tech Solutions Customer Care Team at 1-833-STS-1to1 or customercare@securedtechsolutions.com

Accidental Damage Protection Plan Options (6th-8th) #6 *

Accidental Damage Protection Plan Options (Freshman) #6 *

Accidental Damage Protection Plan Options (Sophomore) #6 *

Accidental Damage Protection Plan Options (Junior) #6 *

Accidental Damage Protection Plan Options (Senior) #6 *

*Cost covers case ONLY.

Any repairs required due to accidental damage will be an additional cost to the parent/guardian.

To see the repair cost estimates click here.

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Total

$ 0.00

Single Year Protection Acknowledgement: *

I acknowledge that my device is covered from 8/01/2023 (or date of coverage purchase) through 7/31/2024. If my device is damaged before 8/01/2023, or before coverage is purchased, this ADP coverage does not apply.

Two Year Protection Acknowledgement: *

I acknowledge that my device is covered from 8/01/2023 (or date of coverage purchase) through 7/31/2025. If my device is damaged before 8/01/2023, or before coverage is purchased, this ADP coverage does not apply.

Three Year Protection Acknowledgement: *

I acknowledge that my device is covered from 8/01/2023 (or date of coverage purchase) through 7/31/2026. If my device is damaged before 8/01/2023, or before coverage is purchased, this ADP coverage does not apply.

Four Year Protection Acknowledgement: *

I acknowledge that my device is covered from 8/01/2023 (or date of coverage purchase) through 7/31/2027. If my device is damaged before 8/01/2023, or before coverage is purchased, this ADP coverage does not apply.

Case Only Protection Acknowledgment: *

I acknowledge that I am only purchasing a case to protect my student's device. Should damage occur, I acknowledge that I will be responsible for that repair cost.

Credit Card Number *

This card will be charged monthly, on the 15th of each month, until your payment has been made in full.

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Expiration Month *

Expiration Year *

Security Code *