ࡱ> gfO bjbj3O3O  XQ%eQ%e F F 84 l:wJ^ jp:r:r:r:r:r:r:$<Q?:r("Jrr::r:p:rp:66T9y7\::0:7?d?8T9?T9rrrrrrr:: prrr:rrrr?rrrrrrrrrF Q:  INSTRUCTIONAL TECHNOLOGY REQUEST FORMApplicant should complete all sections when seeking approval to implement a new instructional technology software, hardware or program subscription (grant-supported or otherwise), and when planning to initiate partnerships or collaborative agreements with various community organizations.  HYPERLINK "https://aikenschools.sharepoint.com/sites/MathLab/Shared%20Documents/General/Instruction%20and%20Technology%20Collaboration/Instructional%20Technology%20Approval%20Process%20Flowchart.pdf" Approval Process ChartGENERAL INFORMATION School: ____________________________________________________________ Principal: ___________________________________________________________ Application Prepared by: ______________________________________________ Name of Proposed Technology: _________________________________________ Program Start Date: ________________ Program End Date: ________________ CURRICULUM SUPPORT SECTION Purpose of the proposed technology: _______________________________ Which content area or curriculum does the technology support? _________ Has this program been approved for use in another school? If so, which school(s)? ____________________________________________________ What does this program offer that existing programs do not? ____________ _____________________________________________________________ Evidence of need for such a program: ______________________________ _____________________________________________________________ Specific objectives of program: ___________________________________TECHNOLOGY SECTION Is this purchase for software, hardware or a program subscription? ________ Does the technology require student accounts? ______________ Has the Vendor Evaluation Form (VEF) been submitted to Technology? ___________________ Does this program include or allow rostering? _________ Does it roster through Clever, Schoology or another program? Name of the rostering program. ________________INSTRUCTIONAL DIVISION SECTION List ways in which this program supports the school districts educational goals and objectives as outlined in the districts strategic plan and the schools renewal plan: _________________________________________________ ____________________________________________________________ ____________________________________________________________ Specifically, list how students will gain academic (primarily) and behavioral benefits from the program: ______________________________________ ____________________________________________________________ ____________________________________________________________ Describe the proposed method for implementing the program: __________ ____________________________________________________________ ____________________________________________________________ Describe the proposed method of evaluation of program objectives: ______ ____________________________________________________________ ____________________________________________________________ Provide a budget proposal and funding source: ______________________ ____________________________________________________________ NOTE: If the program involves mentors or volunteers, please attach the names of the individuals. A reference check should be conducted and documents attached for each individual. ____________________________________ Date: ______________ Signature of Principal ____________________________________ Date: ______________ Signature of Curriculum Support Director ____________________________________ Date: ______________ Signature of Technology Director ____________________________________ Date: ______________ Signature of Executive Director ____________________________________ Date: ______________ Signature of Chief Officer of Instruction ____________________________________ Date: ______________ Signature of Superintendent of Schools  OFFICIAL USE ONLY LEVEL 1 (Action by Curriculum Support) ________ Proposal returned to applicant for modification: _________________________ ________ Proposal denied for: _______________________________________________ ________ Proposal approved by Curriculum Support Vendor Form sent to applicant LEVEL 2 (Action by Technology) ________ Proposal returned to school for modification: ___________________________ ________ Proposal denied for: _______________________________________________ ________ Proposal approved by Technology Department LEVEL 3 (Action by Administration) ________ Proposal returned to school for modification: ___________________________ ________ Proposal denied for: _______________________________________________ ________ Proposal approved at Cabinet as the highest level needed ________ Proposal submitted for Board action LEVEL 4 (Action by Board) _______ Proposal denied _______ Proposal approved with conditions cited: __________________________________ _______ Proposal approved      ()*PK M N    / 0 1 2 F G H M N O 꾶ꞚzodoYNhFhgCJaJhFhlCJaJhFh/CJaJhFh@eCJaJhth/5CJ aJ h2lhj 0Jjhj Uhj jhj Uh/CJaJhgCJaJh@eCJaJhQCJaJhth@e5CJ$aJ$hth/5CJ$aJ$hthg5CJ$aJ$h@ehgjhgUmHnHu)*M 1 zn $$Ifa$gdj  $IfgdQekd$$Ifl#%0%64 laPytt $$Ifa$gd/ $$Ifa$1 2 F G   f g  $Ifgdo$If $$Ifa$gd/ekdg$$Ifl#%0%64 laPytA;-    # ' : < e f g o t {   ^ ߽߹vkkkhFhA CJaJhFhj CJaJhFhtCJaJhFhQCJaJhFhCJaJhthyCJaJhth_|5CJaJh@ehFh&+CJaJhFh_|CJaJhFhg5CJaJhFh@eCJaJhFhgCJaJhFh6PCJaJ*  ^ / m uuuueuedh$If^gdQ & F dh$Ifgdt $Ifgd_| $$Ifa$gd_|ekd$$Ifl#%0%64 laPytA;- " . / m 234FGHNX] +,ynny߄nnnchFhFCJaJhFhH.3CJaJhFhj CJaJhFh6PCJaJhFh`NCJaJhthH.3CJ aJ hthH.35CJ aJ hth/5CJ aJ h_|h/h_|5hFh9iCJaJhFh_CJaJhFhQCJaJhFhA CJaJhFhc=3CJaJ# 34GH,-e~xkxkxkbk $IfgdF & F $IfgdQ$If $$Ifa$gd/ekds$$Ifl#%0%64 laPytA;- & F dh$IfgdQ efLxk[KKdh$If^gdQ & F dh$IfgdQ $Ifgdt $$Ifa$gd9iekd$$Ifl6 #%0%64 laPytQ & F $IfgdQ $IfgdFLVW^_Z[\<c{}ghkǼ~zvvzvzv~zvr~zhoh_|h8*?h@eCJaJh@e htho6B*CJ aJ phhth8*?CJaJhFhj CJaJhFh8*?CJaJhFhQCJaJht6CJ aJ ht5CJ aJ hth9i5CJ aJ hthO5CJ aJ hH.3hFhFCJaJ,LV_[\ $Ifgdtdh$If^gd8*?dh$If^gdj dh$If^gdQ & F dh$IfgdQ \]d{|}~zzzz $Ifgd_|$If$dd$If]d^da$ekd$$Ifl#%0%64 laPyttEfghijk(RSTUVW $Ifgdo$If $Ifgd_|'5QRTW{  (1B]^_hiv{5k  1gMSTghpqѼڷ hWl5hO5CJaJhR}hZ;hqfhO hO5 h@e5h@e5CJaJh8*?h@eCJaJhoh@eh_|HW  ^_v $$Ifa$gdO $$Ifa$ekd$$Ifl#%0%64 laPytQ $IfgdO$If _6 ~uuuull $IfgdZ; $IfgdO $$Ifa$gdOekd$$Ifl#%0%64 laPytA;- $If^$If 2KL $IfgdO $$Ifa$gdOekd$$Ifl#%0%64 laPytA;- LMgh $If^$If $$Ifa$ekd$$Ifl#%0%64 laPytA;- hajhaUh@eCJaJhZ;h@eekd$$Ifl\#%0%64 laPytA;- ,1h/ =!"#$% nRh2Hтl}@PNG  IHDR@QMPLTE# C:J2BAAҽ?@D534ppsOPTyz|sopZ[_ !2,Edcc8>BE0./;LGHM0C?=LʥQRT__cy~XbݸUέGmש_n!C8]V/fˑ?ˍ6:_mMJף,BzȈ߹Ȅo?k#Ɵ٥n{.Lt0IDATxCFI0`mb1@l3Im6iv76miK{Ic l$o[XyIIIIIIIIIIIIIIIIIIIIIIIII]G1MQ4.EӔYG{ܗ $IiL< #ؽC%ڥ2@̾ GB ''RG/&n&PSa}$rO3̅6@O>p'~d&|8jlI~RTv F/b1_A]#xwwa-8 X:A\yӹ{5#:$@]t^`='8RqHy2vy)Q:{s 48NPq]H: ONן].xM!n 7sg߿y4F&fɕ\݊Tν|~ kE#6Q9}~EM$. ?"ysv쑈,`^1Ds߯אָC>-&5AY!X^gP&ó_Ww`T vloXLHLcHfWDK84ӟKjLP޹u`'H35 &2#~B:a <'6g <}u{,Pbb(Լ,C A4S$H1hU/e ;Y桷TM̝fIjnsNڅEh/r7i X&UoDW'K@mWMS&;iTݣ@YLwCsgMU42FPBw & p5o=e^/p3pw]d j}]|,fyr/(ل`m1m s3~=hHä?>{{+T:{Y& jnHYL`h!ӏo 9Ԙ؀lN\K18YCw2Dr \9M: l?w3gPDz ҹF. 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