JSU- ATiM Request for Services

Thank you for your interest in JSU Technology in Motion. Please fill out the following form and someone will be in touch with you as soon as possible. Keep in mind that not all dates can be honored due to prior commitments or obligations, so the more flexible you can be with dates the better. Please note that fields marked with an asterisk (*) are required.
Person requesting workshop
Your answer
District
Name of School(s)
Your answer
Email of contact requesting workshop
Your answer
Cell number of contact
(In case I need to contact you prior or on the road)
Your answer
School or office phone number
Your answer
Focus of Support
What date are you requesting? What time will the first workshop begin? (if multiple, indicate at the end)
MM
/
DD
/
YYYY
Time
:
If training on a single date, choose it again below. What time will the final workshop end that day?
MM
/
DD
/
YYYY
Time
:
If multiple groups are being trained in a day, how long is the total workshop time? (note: anything less than 45 minutes is difficult to achieve)
Besides the above dates, are there other dates you want considered?
(not required)
Your answer
What is the location of the workshop?
Your answer
Will participants have their own devices or access to them in a lab for this workshop?
What equipment should the specialist bring for this location?
(Example- projector, extension cord, screen, Apple TV, etc.)
Your answer
Additional Information
Is there a regular schedule you want for training (monthly, quarterly)? Consider your Educate AL surveys, CIP, and other data--- Is there a focus you want me to use to customize training? Also consult my website for some ideas. http://jsutim.org
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms