Application Form

Please complete the following question to
enter the 2012 Samsung K-12 Grant Program

Requirements:

1. Applicant must be currently teaching in a U.S. school
2. Intention to use the Samsung Document Camera in the classroom
3. Submit Application on or before June 15, 2012

Teacher

What grade do you teach?

What subject(s) do you teach?

Art
English
Comp Sci
History

Math
Science
Other
Multi-discipline

Number of students at your school

Number of document cameras at your school

Please have a representative contact my technology coordinator/principal regarding the SAMCAM 860.

Name
Position
Email
Phone

School

Address 1

Address 2

City

State

Zip

Phone

I agree to the Terms and Conditions.

"Turn off the lights. Tell us what you see."
In 100 words or less how can the SAMCAM 860, with superior low light capability, will be used in your classroom?

Application Form

Please complete the following question to enter the 2012 Samsung K-12 Grant Program

Requirements:

Please complete the following question to
enter the 2012 Samsung K-12 Grant Program