Name
*
First Name
Last Name
Email
*
Title
*
Phone
*
(###)
###
####
Type of Room
How is the space currently being used?
What is the new purpose of the space?
Grade/Age of Students who will use space?
Typical Number of Students?
What do you want learning to look like?
Please check any visual communication elements needs.
If this is a library, how many books need to be housed? How much shelf space will you need?
Are you looking to replicate this space across the school/district? If so - for all ages or age specific?
How often do the students work in a collaborative group setting?
Always
Sometimes
Never
Will the room remain in instructional or group learning configurations or will there be a need for mobility and flexibility for both?
Fully instructional
Fully group learning
Flexible
If collaborative, how many students in a typical group?
If this is a Flex Space (meaning desk seating vs soft seating vs activity tables/media areas), please share how the space will be used.
Sit/Stand? Would you like a mix of heights of desks/tables in the space, or the ability for a desk to move from sit to stand?
What types of Technology do you expect to be used in the space?
Do you have a specific “Front of the Classroom” established?
Yes
No
Unsure
If you need mobile stands or charge carts for the technology, please indicate below.
Do you have outlets or drops currently in the space?
Yes
No
Unsure
Will you need mobile power available to the students/teacher?
Yes
No
Not sure
Anticipated Install Date:
MM
DD
YYYY
Please mark all presentation items of the space that you would like us to provide to you below:
Would you like to see the rough draft 2D and specs prior to moving to space planning?
If you choose this option, you have 24 hours to return with approval or edits to maintain the lead time provided. Failure to do so may result in a delay.
Please include any additional ideas, needs, wants, goals, colors, specific items, preferences, etc. here.
