Accidental Damage Protection (ADP)

Second Semester Enrollment

Accidental Damage Protection for your student issued device protects you from incurring repair costs due to accidental damage and theft. Enrollment is only open to new students to Warsaw and second chance coverage students (as approved by Warsaw), grade K-12. This protection will cover your student’s device through 07/31/2024.

- Step 1 of 3

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Confirm Email

How many students/devices are you registering? *

Student #1

Student Name *

First

Last

Student Grade *

STN (Student Testing Number) *

The STN can be found IN ORANGE on your student's powerschool page. Please call 574-371-5049 for assistance if you are unable to locate your STN in PowerSchool. Please do NOT complete this form without the STN.

Enrollment Date *

This date will be verified with the school.

Student #2

Student Name #2 *

First

Last

Student Grade #2 *

STN (Student Testing Number) #2 *

Student #2 Enrollment Date *

This date will be verified with the school.

Student #3

Student Name #3 *

First

Last

Student Grade #3 *

STN (Student Testing Number) #3 *

Student #3 Enrollment Date *

This date will be verified with the school.

Student #4

Student Name #4 *

First

Last

Student Grade #4 *

STN (Student Testing Number) #4 *

Student #4 Enrollment Date *

This date will be verified with the school.

Student #5

Student Name #5 *

First

Last

Student Grade #5 *

STN (Student Testing Number) #5 *

Student #5 Enrollment Date *

This date will be verified with the school.

Student #6

Student Name #6 *

First

Last

Student Grade #6 *

STN (Student Testing Number) #6 *

Student #6 Enrollment Date *

This date will be verified with the school.

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Acknowledgement of Coverage *

I acknowledge that my device is covered from 1/8/2024 (or date of coverage purchase) through 7/31/2024. If my device is damaged before 8/31/2023, or before coverage is purchased, this ADP coverage does not apply.

Total

$0.00

Payment

Authorize.Net *

Card Number

Expiration

Security Code

Date / Time

Date

Time