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Equipment Request Form - Mepham HS
* Indicates required question
Email
*
Record my email address with my response
Teacher's Last Name
*
Your answer
Teacher's First Name
*
Your answer
Resources
*
If you select "other" (i.e., Microphones, headphones, Breakout EDU Kits, ELMO etc.) please provide information in the comments section below.
Desktop Computers
SMART Board
DVD Player (Laptop)
Large tables (6) for group work in the library
Other:
Required
Location
*
Where is your preferred location? Please note the location will be determined by the tech staff.
Classroom
Learning Center (29 Computers)
Library Main Seating Area
Library (28 Computers)
Room 303 (24 computers)
Required
Classroom Number (For Deliveries Only)
Your answer
Date(s)
*
What date(s) do you need these services? Please use this format mm/dd.
Your answer
Period(s)
*
Period 1
Period 2
Period 3
Period 4
Period 5
Period 6
Period 7
Period 8
Period 9
After School
Required
Do you need a Website unblocked?
Please provide the exact URL. Requests will be reviewed by Joseph Innaco within 48 hours.
Your answer
Comments
*
Please provide the # of students that need the requested resources and any further information about your assignment that might help us to serve you better.
Your answer
A copy of your responses will be emailed to .
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