Digital delivery form

Please complete this form, so we can work with you to fulfill your digital needs and answer any digital delivery questions you may have. If you are in the beginning stages of implementing your digital system, answer the questions to the best of your knowledge.

Fields with an asterisk(*) are required.

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*

Digital delivery system information

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? Yes No If you answered yes, please explain.
4. How long have you provided digital content delivery to your schools or educational facilities? Not yet implemented 1–6 months 7–11 months 1–2 years More than 2 years

Schedule and budget

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?

Content requirements

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

List already determined

Interested in a suggested list of titles

Interested in the entire collection

2. California Streaming 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?

Pre-Kindergarten

Primary K-2

Intermediate 4-6

Junior 7-9

Senior 10-12

Educator

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