Franklin Township ADP Enrollment Form - Secured Tech Solutions

Accidental Damage Protection Coverage

Open Enrollment Closes on September 9, 2024 at 11:59 PM EST

Days

Hours

- Step 1 of 3

Email *

Parent / Guardian Name: *

First

Last

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 Level *

Student ID Number *

Accidental Damage Protection Coverage *

Dell Service Tag Number*

What is a Dell Service Tag Number? Description here.

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

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

Student #2

Student #2 Name *

First

Last

Student #2 Grade Level *

Student #2 ID Number *

Accidental Damage Protection Coverage (Student #2) *

Student #2 Dell Service Tag Number*

*What is a Service Tag Number? Description here.

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

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

Student #3

Student #3 Name *

First

Last

Student #3 Grade Level *

Student #3 ID Number *

Accidental Damage Protection Coverage (Student #3) *

Student #3 Dell Service Tag Number*

*What is a Service Tag Number? Description here.

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

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

Student #4

Student #4 Name *

First

Last

Student #4 Grade Level *

Student #4 ID Number *

Accidental Damage Protection Coverage (Student #4) *

Student #4 Dell Service Tag Number*

*What is a Dell Service Tag Number? Description here.

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

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

Student #5

Student #5 Name *

First

Last

Student #5 Grade Level *

Student #5 ID Number *

Accidental Damage Protection Coverage (Student #5) *

Student #5 Dell Service Tag Number*

*What is a Service Tag Number? Description here.

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

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

Student #6

Student #6 Name *

First

Last

Student #6 Grade Level *

Student #6 ID Number *

Accidental Damage Protection Coverage (Student #6) *

Student #6 Dell Service Tag Number*

*What is a Dell Service Tag? Description here.

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Total

$0.00

2024 - 2025 School Year Protection Acknowledgement: *

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

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