Digital delivery form

First name*

Last name*

Title

School or organization*

Address

Address 2

City

State

Postal code

Phone number*

E-mail address*

Fax number*

Best time to call*

School, Media Center, District, or Public Library Name*

Address

Address 2

City

State

Postal code

Digital delivery system (i.e., CISCO, Rauland-Borg, etc.)*

1. How many schools or educational facilities will have access to your system?*

Elementary*

Middle*

High*

Other

2. Are you looking for an Internet-based streaming video solution, or do you plan to host the content locally?*

3. Do you currently own or license any other digital content?

If you answered yes, please explain.

4. How long have you provided digital content delivery to your schools or educational facilities?

1. If digital delivery has not yet been implemented in your schools or facilities, on what approximate date will your system be operational?

2. What is your budget for digital delivery content?

1. Have you determined which titles you will need, or would you like us to assemble a suggested list of titles?

2. PowerMediaPlus can provide a customized quote based on your digital video needs. In order for us to suggest appropriate titles, please provide the following information.

Which grade levels?

Which subject areas?
Hold down the Ctrl key (Command on the Mac) to select more than one subject.

When do you need the suggested list of titles?

Are you interested in still image content (photos, illustrations, etc.)?