Classroom Design Questionnaire

Fields marked with an asterisk * are required.

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Contact Information

* Email Address:
* First Name:
* Last Name:
Organization:
Address:
City:
State:	-- Select One -- OTHER - Outside N.America Alabama, US Alaska, US Arizona, US Arkansas, US California, US Colorado, US Connecticut, US Delaware, US District of Columbia, US Florida, US Georgia, US Hawaii, US Idaho, US Illinois, US Indiana, US Iowa, US Kansas, US Kentucky, US Louisiana, US Maine, US Maryland, US Massachussets, US Michigan, US Minnesota, US Mississippi, US Missouri, US Montana, US Nebrask, US New Hampshire, US New Jersey, US New Mexico, US New York, US Nevada, US North Carolina, US North Dakota, US Ohio, US Oklahoma, US Oregon, US Pennsylvania, US Puerto Rico, US Rhode Island, US South Carolina, US South Dakota, US Tennessee, US Texas, US Utah, US Vermont, US Virginia, US Washington, US West Virginia, US Wisconsin, US Wyoming, US Alberta, CA British Columbia, CA Manitoba, CA New Brunswick, CA Newfoundland, CA Nova Scotia, CA Ontario, CA Prince Edward Island, CA Quebec, CA Saskatchewan, CA Northwest Territories, CA Nunavut, CA Yukon Territory, CA Aguascalientes, MX Baja California, MX Baja California Sur, MX Campeche, MX Chiapas, MX Chihuahua, MX Coahuila de Zaragoza, MX Colima, MX Distrito Federal, MX Durango, MX Guanajuato, MX Guerrero, MX Hidalgo, MX Jalisco, MX Mexico, MX Michoacan de Ocampo, MX Morelos, MX Nayarit, MX Nuevo Leon, MX Oaxaca, MX Puebla, MX Queretaro de Arteaga, MX Quintana Roo, MX San Luis Potosi, MX Sinaloa, MX Sonora, MX Tabasco, MX Tamaulipas, MX Tlaxcala, MX Veracruz-Llave, MX Yucatan, MX Zacatecas, MX
Zip:
State(other):
Phone:
Fax:
* Entity:	-- Select One -- Corporate Primary Education Secondary Education College/University Education Student Medical Institution Government Military Individual Design Integrator Reseller Other

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Project Information:

Project Name:
When do you need delivery?
Shipping Zip:
Is there a loading Dock?	Yes No
Quote optional inside delivery?	Yes No
Is an elevator available for delivery?	-- Select One -- No Freight Passenger/Freight Delivery to entrance floor

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The Space: Room Dimensions and Features

Room Width:
Room Length:
Ceiling Hight:
Columns and Pilasters:
Windows?
Doors:
Other Features:

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Classroom Function:

Grade/Age Level:
Session Length?
Number of Students:
Terminals to be Shared?	Yes No
Notes on Function:

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Student Station Details:

Select Priority	-- Select One -- Instructor Chalkboard Collaborative Work Lab / Testing Privacy
Platform	-- Select One -- Fixed CPU Laptop Both at station Mixed None
Select CPU Case	-- Select One -- Desktop Tower All-In-One Rackmount
Select Monitor	-- Select One -- LCD CRT Multi-head LCD All-In-One
Additional Equipment:
Student Station Notes:

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Instructor Station Details:

Desired Configuration	-- Select One -- Stand-up Desk Sit-Stand Desk Standard Desk Lectern
Line-of-Sight To:
Platform	-- Select One -- Fixed CPU Laptop Both at station Mixed None
Select CPU Case	-- Select One -- Desktop Tower All-In-One Rackmount
Select Monitor	-- Select One -- LCD CRT Multi-head LCD All-In-One
Additional Equipment:
Instructor Station Notes:

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Equipment/Instructional Tools In Room:

Network Printer(s):
LCD Projector:
Projection Screen:
Marker Board
Interactive Markerboard
Acoustical Tackboard
Storage Requirements
Other Equipment/Comments:

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Other Notes and Concerns:

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