Makey Makey: ABC CREATE Resource Request Form

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First and Last Name *

School District/Organization *

Email Address *

Phone Number (Best Contact) *

Beginning Borrow Date

* Please check the ABC CREATE Makey Makey calendar to make sure this resource is available during the dates you wish to borrow.

YYYY

End Borrow Date *

YYYY

With what grades will you use this technology? *

Please specify the topic or subject matter, if applicable, for which you will use this technology. If not applicable, please provide a brief (couple of sentences) overview of your classroom implementation -- or type NA. *

Please estimate the total number of students you expect will use this technology. *

From the total number of students listed above, please provide an estimated breakdown by gender. *

How many classroom sets do you need? *

1 Classroom Set (15 Makey Makey boards for up to 30 students)

2 Classroom Sets (30 Makey Makey boards for up to 60 students)

Any additional questions or comments

I have read the Teacher Agreement, and I understand and accept its terms. *

Submit

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