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Thank you for submitting your information!

Next Steps

Agency Staff will:

  • Review waiver form submissions
  • Seek clarifying information if needed
  • Determine if a site visit is needed
  • Make a final determination and contact school staff

Step 1: Provide General Information

Contact Name:   {{Response.ContactFirstName}} {{Response.ContactLastName}}
Contact Role:   {{Response.ContactRole}}
Contact Phone:   {{Response.ContactPhone}}
Contact Email:   {{Response.ContactEmail}}
District Name:   {{Response.Title}} ({{Response.DistrictRCDTS}})
District Name:   {{Response.OtherDistrict}}
School Name:   {{Response.SchoolName}} ({{Response.SchoolRCDTS}})
School Name:   {{Response.OtherSchool}}

Step 2: Provide Technology Information

Total Number of Student Devices in the District:
Internet Service Provider: {{Response.ISP}}
Type of Connection: {{Response.ConnectionType}}
Total Network Bandwidth: {{Response.Bandwidth}}

Step 3: Provide Additional Information and Submit

Describe the technology limitations, please include Pearson Helpdesk ticket numbers when appropriate: {{Response.Justification}}
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Contact Information