Sanford PROMISE Equipment Lending Library Equipment Request

Sanford PROMISE Equipment Lending Library Equipment Request

Sanford PROMISE believes every student should have access to the resources (quality teachers, relevant lessons, high-tech equipment, and mentors) to pursue careers in science and research. As a result, we are committed to sharing over $40,000 of resources and supplies with schools. Please view our lending library catalog for examples of our equipment and some lessons that we have created using our equipment.

Educators requesting equipment will be asked to return the equipment in the condition it was borrowed by the date negotiated to allow others to utilize the supplies. Failure to return in the condition it was borrowed in or if not returned in a timely manner may result in having future opportunities removed. All equipment must be reserved using this request form. All equipment is available on an as needed, as requested manner and completions of the request form are met in the order in which they are received. First priority is always given to educators who have attended Sanford PROMISE educator workshops.

1. Dates for Reserving Equipment

Reservation Dates Note: if you are flexible on timing, including this ensures we can fulfill the largest number of requests:

Pick-Up Day*

Start Date for usage of the Equipment*

Return Day*

2. Information:

First Name*

Last Name*

School/Organization Address*

Address Line 1

Address Line 2

City

State

We are currently limited to a few states in the upper mid-west. If your state is not in the listed states please contact the PROMISE lab @ Sanfordoutreach@sanfordhealth.org before you place your request.

ZIP Code

Contact Email*

Backup Email

Please provide a non @k12.sd.us email address as schools have blocked our emails in the past.

Contact Phone*

Age range of students

Select or enter value

Course Taught*

3. Equipment

What equipment do you need to borrow?*

Please select all that apply

Select or enter value

What other equipment would do you need

4. Classes

Tell us about how many students you have in each of the classes using the equipment

Number of Classes*

Select or enter value

Number of students Class 1

Number of students Class 2

Number of students Class 3

Number of students Class 4

Number of students Class 5

Number of students Class 6

Number of students Class 7

Number of students Class 8

Number of students Class 9

5. School Demographics

(note: much of this information is available on the department of education district report card if needed):

School District

Select or enter value

Please write your district below. Example (Viborg-Hurley 60-6)

Towns/Communities Served*

Size of Town/community*

Does your school qualify as Title 1*

% Free/Reduced*

% American Indian*

% Minority*

Number Student/Grade Level*

6. How would you like to receive the equipment?

When possible, we try to directly hand off materials. Please identify whether shipping will be necessary and any special accommodations for shipment (note: some equipment is unable to be shipped).

Options*

Select or enter value

7. Please describe how this activity fits into your curriculum/unit:

Curriculum/unit

8. Additional concerns

Explain/describe any concerns about conducting this activity (methods, techniques, timing, content, etc.):

Concerns

9. Video conference

Would you like to arrange an Interactive Video Conference with someone from the PROMISE Team or a researcher from Sanford Research? View a list of researchers.

Video Conference

Select or enter value

10. Please describe any other needs:

Other Needs

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