Contact Information (Applicant)

1. Name*:
2. Title:
3. Email address*:
4. Telephone*:
5. Street:
6.  
7. City:
8. State:
9. Zip:

Project Information

1. New School Construction
2. Renovation


3. Project Name:
4. School Type:
5. # of Classrooms:
6. Funding Source:


7. Architect:
8. Architect Website:


9. Consultant:
10. Consultant Website:


11. Dealer/Installer:
12. Dealer / Installer Website:


13. Start Date:
14. End Date:

Current Classroom Technology Found In District(Check all that Apply)

1. Component % of Rooms (approx.)


2. Projector:
3. Television:
4. Interactive White Board:
5. Teacher Computer :
6. Amplifier/Speakers:
7. DVD Player or VCR:
8. Wireless Microphone:
9. Document Camera:
10. CATV Tuner:
11. iPod / Podcasting:
12. Wireless Ethernet:
13. Other:

Equipment Provided By Calypso Under the Grant Program

1. Calypso will provide the ezRoom5000 with these additional pieces of equipment:
   • WCM-RF Wireless Microphone
   • All CAT5 Cables Needed
2. Calypso will NOT provide any other equipment outside of the previously above mentioned gear! This would include, but not be limited to the following:
   • Interactive Whiteboard
   • Projector or LCD Display
   • Document Camera
   • Laptop and/or PC

How Will These Technologies Fit Into Your Technology Plan?In addition, please answer what you hope to gain from this evaluation.