BEDS Code of Institution:   ____________________________ (If you do not have an SED issued BEDS code, please contact the Office of Information, Reporting, and Technology Services at 518-474-7965.)

Name of Institution:    __________________________________________________________

Address of Institution: _________________________________________________________

____________________________________________________________________________

Primary Contact:    ______________________________ Title: ________________________

Email Address:    _______________________________________________________________

Phone Number: ______________________ FAX Number: ________________________

Indicate whether the institution has access to Internet WEB capability:  Yes: ___ No: ___

The institutions will be judged on their ability to demonstrate in narrative format the following:

• Demonstrate institutional need for requested surplus equipment.
• Demonstrate how the computers that would be part of their current technology plans.
• Demonstrate how staff development needs will be addressed in operationalizing the computers.
• Demonstrate how the computers will be used for school/educational improvement.
• In the case of a private school, state that the requested equipment will be used solely for secular educational purposes and demonstrate how the school will comply with the requirements for private schools established in the CREATE guidelines.

Please attach the narrative on a separate paper and send along with your completed application to: 

New York State Education Department, Student Support Services Team, Room 318M, Education Building, Albany, New York 12234. Attention Joe Leffler
OR,
 FAX to: (518) 474-8299, Attention Joe Leffler

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Click here for application to Repair Surplus Computer Equipment for Instructional Training