EPIC Resource Library Request Form: Catalyst•Kutztown
~~ Catalyst•Kutztown Satellite ~~

IMPORTANT NOTES: PLEASE READ
• Review listing for dates for availability.
• Items will be delivered and picked up by the BCIU delivery service.
• Items can be borrowed for a maximum of two weeks (extensions can be requested).
• Please complete this item request form at least one week prior to requesting date.

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Your Name *
Email Address *
What grade level do you teach? *
Required
School District or Private School *
Catalyst•Kutztown Site (for Catalyst•Berks districts: https://forms.gle/em17LSRjdCEBjx5k6)
If other was selected, enter it here (optional)
School Building *
This will be the building to where the items will be delivered.
Equipment Requesting *
Please note: Finch 2.0 will be available Spring 2020.
Number of Kits Requesting *
Beginning Borrow Date *
*Please leave at least one day for charging.
MM
/
DD
/
YYYY
Return Date *
MM
/
DD
/
YYYY
I have verified the hardware and software requirements and either: (1) Have Everything I need OR (2) Made arrangements with my building/IT to ensure I will have the computing devices and software/apps necessary for the equipment. *
Experience with Requested Item *
What grade levels will be using this equipment? *
Required
Approximate number of students using equipment *
Additional Comments/Questions
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