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Filter Change Request Form

This form is only to be used to provide permanent unrestricted access to a web site for all staff and students. For staff only access on an as needed basis, please submit a Technology Request for a username and password to override the filter as needed.

Please complete the form below. Required fields marked *

Name*

Answer Required

E-Mail Address*

Answer Required

Web site to be accessed*

Answer Required

Certification that site is an educational site*

By checking Yes, you are certifying that the site is an educational site and ties to the educational standard listed below

Answer Required

Yes

Educational Standard Met*

Please list the educational standard met by students utilizing this web site

Answer Required

Certification that site only includes appropriate educational material*

By checking Yes, you are certifying that the site you are requesting is appropriate for a school environment and for all school students, plus does not include links to other sites that contain inappropriate content.

Answer Required

Yes

Other pertinent information regarding your request

Answer Required