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Curriculum Request Form
Extension Request Form
The maximum number of form submissions has been reached. This form is currently not available.
The purpose of this form is to provide St. Thomas More Catholic School (STM) a process to review electronic curriculium materials used for educational purposes. All materials used will be reviewed for compliance with the
Children's Internet Protection Act (CIPA)
which requires that K-12 schools and libraries in the United States use
Internet
filters and implement other measures to
protect children
from harmful online content. Teachers and Staff who use materials which have
NOT
reviewed through this process retain all liability.
Completed requests should be processed within 7 days.
If additional information is needed, the
Curriculum Review
Team will contact you.
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Email
REQUIRED
Please fill out this field.
Please enter an email address.
Website Name
REQUIRED
Please fill out this field.
Please enter valid data.
What Web Addresss Is Used to Locate the Software/App/Extension
REQUIRED
Please fill out this field.
Please enter valid data.
Title of Product
REQUIRED
Please fill out this field.
Please enter valid data.
Cost for Educators
REQUIRED
Please fill out this field.
Please enter valid data.
How long does this software need to be available for use?
REQUIRED
(Select One)
One Month
One Quarter
One Semester
One Year
Please fill out this field.
Media Type
Software
Website
Android App
iPad App
Chrome Extension or Add-on
Licenced for Commercial Use? or Single User
REQUIRED
Single User
Commercial
Please fill out this field.
How did you find out about this product?
Please enter valid data.
Curriculum Strand or Objectives Covered by this product:
REQUIRED
Please fill out this field.
Please Identfy the Staff and/or Grade Level(s) who will need this App?
REQUIRED
Please fill out this field.
Please enter valid data.
Are Additional Student Accounts Required?
REQUIRED
Yes
No
Please fill out this field.
Teachers Can Track Student Progress Throughout the Program
REQUIRED
Yes
No
Please fill out this field.
Content and Images are Consistent with Our Catholic Faith and Respectful of Diverse Languages and Cultures
REQUIRED
Yes
No
Please fill out this field.
Are Supplemental Materials Required? (Headphones, Camera, Workbooks, etc.)
Yes
No
If Supplemental Materials Are Required, Please Explain.
How Will This Product Enhance Student Instruction and Learning?
REQUIRED
Please fill out this field.
Submit
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