Verizon Innovative
Learning Schools
Pre-Qualification Survey

Step 2: Submit Pre-Qualifying Survey

Directions: The following questions must be answered in full. Not completely answering any question will result in your survey being disqualified.
Surveys must be submitted by March 11, 2013 (Midnight EST).

The survey submission period for the 2013-15 VILS Program is now closed. We will directly contact those
schools selected to continue the application process. Thank you for your interest in this program.

Qualifying Statements (Required)

1. Identify your educational institution:

2. Does your school have a 1:1 or 2:1 mobile technology initiative in place, and if so, was it in place prior to January 2013?

3. Does your school have confirmed plans to continue the 1:1 or 2:1 mobile technology initiative for the entirety of the 2013 - 2014 and 2014 - 2015 school years?

4. Indicate which grades will be part of project (check all that apply)

5. How many students in educational institution qualifying for free/reduced lunch? [Please enter value as %. Only values between 40 and 100 will be accepted.
Please do not submit if you do not meet these criteria.]

%

Further Information (Required)

6. Name of Applicant

Applicant's Role or Title

Applicant's Email Address

Applicant's Phone Number

7. Full Name of School

8. District

9. Full Address

10. Grades taught at school

11. Estimated number of participating students

12. Number of participating teachers

13. Total number of teachers and students in school

Open-Ended Responses (Required)