This form is for KLSD employees to request software or website use to be available in the District. Please complete the form for each piece of software you would like to request.

NOTE: All requests are tentative based on review of compatibility, appropriate funding, and licensing information.
Name/Title: 
(If you are applying for more than one individual, please list all user names). 

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* 1. Name/Title: 
(If you are applying for more than one individual, please list all user names). 

Building (Check all that apply)

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* 2. Building (Check all that apply)

Direct Phone Extension 

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* 3. Direct Phone Extension 

Name of Software/Website Requested:

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* 4. Name of Software/Website Requested:

Software download available

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* 5. Software download available

Software Publisher Website and website link:

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* 6. Software Publisher Website and website link:

Please enter the software Version Number (or “I Don’t Know” or “Latest” are examples)

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* 7. Please enter the software Version Number (or “I Don’t Know” or “Latest” are examples)

Main use for software/Website: 

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* 8. Main use for software/Website: 

Planned use of software/website - please click those that apply: 

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* 9. Planned use of software/website - please click those that apply: 

How will this software/website benefit student learning?

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* 10. How will this software/website benefit student learning?

Software/Website included methods to monitor student progress (reports for student and/or family)

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* 11. Software/Website included methods to monitor student progress (reports for student and/or family)

Enter the # of students who will be impacted by using this software/website:

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* 12. Enter the # of students who will be impacted by using this software/website:

Number of licenses requested (please be specific: number per building, and if there is  a building or district license being requested.

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* 13. Number of licenses requested (please be specific: number per building, and if there is  a building or district license being requested.

Where do you want the software/website access installed (please be specific, room number, exact computers)?  

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* 14. Where do you want the software/website access installed (please be specific, room number, exact computers)?  

How will you evaluate the effectiveness of the software/website? 

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* 15. How will you evaluate the effectiveness of the software/website? 

What kind of log in does the software/website have?

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* 16. What kind of log in does the software/website have?

Is the software /website free?

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* 17. Is the software /website free?

Cost of intial software/ website access and projected maintenance costs 
(renewals, upgrades, etc....)

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* 18. Cost of intial software/ website access and projected maintenance costs 
(renewals, upgrades, etc....)

Funding Source:

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* 19. Funding Source:

Does this software/ website need to be renewed annually? 

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* 20. Does this software/ website need to be renewed annually? 

Date Required

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* 21. Date Required

Have you read the data privacy for the software/ website?

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* 22. Have you read the data privacy for the software/ website?

Please insert the website link to the data privacy page:

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* 23. Please insert the website link to the data privacy page:

Where did you find out about this software/ website? Have you used it before?

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* 24. Where did you find out about this software/ website? Have you used it before?

Has this software/ website been approved by an administrator? If Yes, please add the name of the administrator in the "other" space below

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* 25. Has this software/ website been approved by an administrator? If Yes, please add the name of the administrator in the "other" space below

By typing your name below, you are confirming that you read the Requesting Software Procedure criteria and overview regarding this software/ website request.  

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* 26. By typing your name below, you are confirming that you read the Requesting Software Procedure criteria and overview regarding this software/ website request.  

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