Midzi Schools Application Form

The Application form below is a preliminary form, that will help us get to know you, and the school. Filling out a form will not guarantee that you will be accepted as a recipient for this project, but we are very open to working with you and your students. We would like to reach out to as many classrooms as we can.
You may also download and print a copy of the same application form in the file below! To submit a printed form, you may fax the form back to us, or send it by email.
I look forward to getting to know you, and working with you... in bringing great learning opportunities in your community.

midzi_schools_application_form.pdf
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Midzi Schools Application Form

* Indicates required field

Your Full Name *

First

Last

Your Email *

Your Phone Number *

FULL Mailing Address of School needing sponsors *

Line 1

Line 2

City

State

Zip Code

Country

3. FULL NAME of the School Principal, and his phone number and email. *

4. Would you tell us a little about yourself? What is your relationship to the school or classroom that needs tablets? *

5. Can you briefly tell us about the school or classroom? *

6. What provision does the school have for students to have internet access? *

7. What provisions does the school have, in regards to an electrical source, to recharge the computer tablets? *

8. Is the classroom teacher, the school principal, and the parents involved in this decision to have computer tablets in the classroom? *

9. Are the school and parents willing to agree to the terms of our Contract? You can view the contract on this website on the tab: Midzi School Agreement. *

10. What plans are in place to train teachers and students on how to use and manage the computer tablets? *

11. Name which grades (classroom) need computer tablets? How many students total (including the classroom teacher), for each grade/class need computer tablets? *

Submit

Midzi Schools Application Form

Telephone

Email

Midzi Schools Application Form