Please fill out the following application to request a Refurbished Computer System (RCS). The Refurbished Computer Program is sponsored by the PATINS Project.
1. Applicant's Work Information (Required) The applicant is usually the Teacher of Record.
Name
County Code-Corporation or District Code- School
[Example 84-8435-3309]
County Name
Corporation or District Name
School Name
Principal and/or Director Name
Principal and/or Director Phone Number
Principal and/or Director email address
If you need assistance in finding your school code, you can look it up at the DOE web page. Just click on the highlighted link,
http://www.doe.state.in.us/publications/schooldirectory.html or copy and paste the following link into your browser: http://www.doe.state.in.us/publications/schooldirectory.html)
2. Applicants Work Address Information (Required)
Street
City/Town
Zip Code
Telephone
Fax
Email
3. Applicants PATINS Regional Site (Northwest, Northeast, Central, Southwest, Southeast)
(If you need assistance in determining which PATINS Regional Site supports you, please check the State Map .
4. Which describes the setting under which the RCS is going to be used .
(Preschool, Elementary, Middle School, High School, Home Use)
5. Please list the minimum hardware requirements for the software you intend to install on this computer. (Required) NOTE: Read your software documentation for the hardware requirements.
Computer Type
Processor Speed
Random Access Memory
Monitor Size
Modem
Network Card
(PATINS will attempt to provide you with your minimum system requirements. However, note that we can not guarantee the provision of a modem, specified monitor size or mouse type.)
Example:
Computer Type: Desktop, Laptop
Processor Speed: 1.5 Ghz
Random Access Memory: 512 mb
Monitor Size: 15"
Modem: Yes, internal 56 Kbps (Most classrooms do not have telephone connections, good for Home Use if the home does not have High Speed connection)
Network Card: Yes (Only needed if you have a network or use High Speed connections (Ethernet)
Notice:
●PATINS Project provides computer systems and equipment "as is".
●PATINS Project, equipment manufacturers and Microsoft provide no follow-up support, technical assistance or upgrades for these systems, software or equipment.
●The computer(s) is (are) provided with Microsoft Windows XP Professional operating system.
●The current Open Office, OxygenOffice Professional Suite will be installed.
.
●Applicant, Contact Person, or end user is required to Read and Accept the End User Lisense Agreement (EULA) that will come up as soon as you turn on the computer, we will pre-activate the Microsoft Operating System for you.
●If the equipment you receive comes from the Indiana State Surplus your Principal or Director will be required to sign and return an Indiana State Excel Spreadsheet form.
●We will provide the FREE ReadPlease Software. It is uninstalled; therefore, if you want it you must install it. It is located in My Download Files Folder.
●We will provide and install the Microsoft Security Essentials software (Anti-Virus, Anti-Spyware) for the XP Pro operating system.
Date of this application request
Name of person completing this request.
Also, please add any comments in this field.