2023-2024 Assistive Technology Consideration Request- OUT-COUNTY/CENTRAL CAMPUS/ LOCAL AAC
The Assistive Technology Lending Library is available to all Jackson County School districts interested in trying a piece of technology or AT support prior to purchasing. Loans can last anywhere from 7-90 days. Upon return of the equipment, districts will be responsible for purchasing (Collect data to support the need and provide to your Special Education Supervisor).  

Sign in to Google to save your progress. Learn more
Email *
Staff member requesting equipment or support? *
Location(district and building) *
Student name or classroom equipment/support will be used for? *
Do you have a broken screen/device? If so, please submit the serial number and we will put in a Tech Help Desk Ticket.
Please list other service providers that may have valuable input into this student's needs (name/title)
What area is this student in need of support for? (related to the request) *
Required
What type of equipment, apps, software and/or support are you requesting? (if you are requesting information or training, skip to the last question and submit).
If you are requesting an app to be added to an ISD iPad you already have, please include serial number (Settings->General->About).
Has the student used this equipment in the past or is this a first time trial? *
How will the AT requested relate to the outcomes of the student's IEP, IFSP, or 504 Plan? (please be specific; state IEP goals/needs) *
How do you plan to collect data on this app or device? Please be specific *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of JCISD. Report Abuse