Vendor Contact Form
Please fill out all fields in their entirety; incomplete applications will not be accepted.
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Vendor Contact Information
Vendor Name: *
Local Representative Name: *
Email Address: *
Office Phone: *
Cell Phone:
Product Information
Product Name: *
Product Description: *
Primary End User: *
Check all that apply.
Is the product web-based? *
Briefly describe the product’s reporting capabilities:
What type of customer service and technical support does the company offer? Please list hours of operation and support type (email, real-time chat, screen sharing, phone, etc.): *
Administrative Concerns
Describe cost or pricing structure. Please attach price list or pricing information as available: *
Projected professional development or training required: *
Is the vendor willing to provide turnkey professional development to BOCES/MORIC staff?: *
Is the vendor willing and able to run pilot implementations? *
Are you aware of at least two MORIC districts interested in purchasing this product? *
If you answered yes to the question above, please provide contact information for the district representatives:
Can the vendor provide at least three endorsements from districts in NYS? *
If you answered yes to the question above, please name the districts.
Is the product currently available via NYS contract? *
Is this product currently being supported by any other BOCES or RIC in NYS? *
If you answered yes to the question above, what BOCES or RIC in NYS is supporting it?
Is third-party research available about the product? *
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This form was created inside of Mohawk Regional Information Center.