1 EmpowerED ™ Program Application At T-Mobile, we recognize that every student needs equal access to learning to succeed academically. Yet, across our country, too many
Mar 19, 2019 · 1 EmpowerED ™ Program Application At T-Mobile, we recognize that every student needs equal access to learning to succeed academically. Yet, across our country, too many
EmpowerEDTM Program Application Please download this application, save it to your computer and then fill it out for best performance. At T-Mobile, we recognize that every student needs equal access to learning to succeed academically. Yet, across our country, too many families with school-age children do not have high-speed internet at home. Without online access to complete homework, these disconnected students fall further behind their connected peers. T-Mobile's EmpowerED initiative is aimed at bridging the "homework gap"--the uneven playing field that exists when millions of low-income students are unable to access the digital tools necessary to succeed inside and outside of the classroom. We're working to close that gap and empower ALL students with the 21stcentury digital literacy and skills that will help them compete in today's digital economy. Eligibility Criteria T-Mobile is now accepting applications from elementary, middle, and high schools, and districts across the US. The criteria for participation in this program are: Required: · At least 40% of students receive free or reduced lunch at each school · Each school is located in an area where TMobile has 4G LTE coverage over at least 80% of the school's geographic enrollment zone. TMobile will validate eligibility for this requirement; to see coverage in your area please check our coverage map. Preferred: · At least 15% or more of students are dropping out of high school (aggregate for all high schools if a school district is applying) · At least 15% of students are not grade-level proficient in math and reading by the 9th grade (aggregate for all high schools if a school district is applying) T-Mobile will select participants based on the criteria, the application, and the interview described under "How to apply." Please confirm that your school/district meets these eligibility requirements. YES NO Program Offer T-Mobile's EmpowerED program provides off-campus devices and data plans to help schools and students succeed. Students must be permitted to take home the devices offered through EmpowerED. EmpowerED Mobile Equipment includes: · Free and/or subsidized mobile internet equipment: Up to $200 total toward mobile Internetequipment, per participating student · Mobile Internet equipment may include: a hotspot, Chromebook, tablet, data stick, laptop or other device EmpowerED Mobile Data Plans include: · Two-year contracts for one of the following discounted education data plans: 1. 2GB for $10: Up to 2GB of high-speed data, followed by data at reduced speeds up to 128kbps. APPLICANTS WITH AT LEAST 80% FREE AND REDUCED LUNCH populations only: You may request a waiver of the $10 cost for the 2GB option during the interview phase of the application process. T-Mobile will award a limited number of waivers in its sole discretion. 2. T-Mobile ONE Unlimited LTE for $20: Unlimited 4G LTE data on a T-Mobile device. Video typically streams on T-Mobile device at DVD quality (480p). On all T-Mobile plans, during congestion the small fraction of customers using >50GB/mo. may notice reduced speeds until next bill cycle due to data prioritization. Tethering at max 3G speeds. Sales tax and regulatory fees included in monthly1service price. EmpowerED Service & Support: · Planning, implementation, and deployment support. · T-Mobile's Web Guard content filter, which helps prevent access to adult content. Web Guard filters http web page content on our network. Web Guard also allows participants to request that specific websites be blocked. Schools participating in EmpowerED that wish to decrypt and filter https traffic also have the option to purchase a non-T-Mobile proprietary service. Schools that do not use a T-Mobile-facilitated filter thereby acknowledge that they will provide their own CIPA-compliant filter on all EmpowerED devices for the duration of their use. Students and their families will not be required to pay any money for devices and/or wireless service received through this program. Primary Contact Information FIRST NAME LAST NAME SCHOOL OR DISTRICT NAME ADDRESS EMAIL PHONE SCHOOL OR DISTRICT WEBSITE CITY STATE All fields required ZIP CODE 1. Statement of Interest Please provide a statement of interest in applying for T-Mobile's EmpowerED technology program. Why should your school or district be a part of this program? How will this technology funding would benefit your student population? If approved, when do you aim to implement the program? 2 2. Overview of Local Education Agency (LEA) A. Please provide a narrative overview of the LEA demographics with special emphasis on the population of socioeconomically disadvantaged students. B. Please provide statistics for the following for the district. Note: whether you are a single school applying, or multiple schools, please provide the statistics for the entire district. SCHOOL DISTRICT HS DROP OUT RATE FOR THE DISTRICT % OF STUDENTS WHO ARE NOT GRADE-LEVEL PROFICIENT IN MATH AND READING BY 9TH GRADE C. For each target school, provide the statistics below, and a link to the most current School Accountability Report Card (SARC). Update the first two schools below. Any additional school should be added on the form on page 6 of this document. SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC 3. Strategic Technology Plan Please provide an overview of your strategic technology plan that includes current and planned efforts, including 1:1 initiatives and devices currently used by students and teachers. 3 4. Information and Instructional Technology Support What information and instructional technology staff does your school or district have in place today? Please indicate whether individual schools have dedicated staff, or whether staff are spread across multiple schools through a shared services model. 5. Current Off-Campus Access Strategies Please describe any specific strategies your LEA implements to enable socioeconomically disadvantaged students to gain access to devices and connectivity for off-campus use. Has the district or school conducted any surveys to determine the percentage of students without internet access at home? YES NO If yes, please provide details; if no, please estimate the percentage of students without access and the methodology used to calculate this estimate. 6. Accidental Damage and Theft Policies Please explain your school or district's plan to address damage and theft of devices. Indicate whether this includes insurance, or involves a process similar to textbook checkout policies. 7. Acceptable Use Policies All eligible applicants must have a current digital acceptable use policy. Please provide a link to your district's policy. link to your district's policy 4 8. Monitoring Requirements All participating schools or districts will be required to: 1) Provide annual aggregated data by grade level at each school, including ELA proficiency, math proficiency, and tardiness/attendance 2) Conduct two anonymous online surveys, created by T-Mobile, about student technology usage with students and teachers. The first survey will be administered prior to the student receiving access and the second will be held at the end of the school year. Do you agree to these requirements? YES NO Please describe your process for obtaining all the necessary monitoring data described above. 9. Are you tax exempt? YES NO If yes, please input your tax exemption code. TAX EXEMPTION CODE 10. Internal Support It is important that school and district leadership have been briefed on this opportunity and understand the information included on this application. I acknowledge that key senior staff, including the CIO, superintendent and associate superintendent of instruction and principals from each target school are aware and supportive of this application. YES NO Submit your application: Once you've downloaded and filled out your application, please submit it via email to EmpowerED@T-Mobile.com Contact EmpowerED: If you have questions about this program, please see our Frequently Asked Questions list, or contact EmpowerED@T-Mobile.com Please refer to the EmpowerED site at www.T-Mobile.com/empowered for important program details. Program eligibility determined in T-Mobile's sole discretion. Capable device required to achieve 4G LTE speeds. Limited time offers; subject to change. Not eligible for other discounts. U.S. roaming and on-network data allotments differ: includes 200 MB roaming. Partial megabytes rounded up. Not for extended international use; you must reside in the U.S. and primary usage must occur on our U.S. network. Service may be terminated or restricted for excessive roaming. Video streaming at up to 1.5Mbps; may affect speed of video downloads. For best performance, leave video streaming applications at default automatic resolution setting. Tethering: For the small fraction of customers using >50GB/mo., primary data usage must be on tablet. Network Management: Service may be slowed, suspended, terminated, or restricted for misuse, abnormal use, interference with our network or ability to provide quality service to other users, or significant roaming. Tablet usage is prioritized over tethering usage, which may result in higher speeds for data used on tablet. See T-Mobile.com/OpenInternet for data management details. Coverage not available in some areas. LTE is a trademark of ETSI. EmpowerED is a trademark of T-Mobile USA, Inc. T-Mobile and the magenta color are registered trademarks of Deutsche Telekom AG. ©2019 T-Mobile USA, Inc. 5 2. Overview of Local Education Agency (LEA) Continued C. For each target school, provide the statistics below, and a link to the most current School Accountability Report Card (SARC). SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC 6 2. Overview of Local Education Agency (LEA) Continued SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC SCHOOL NAME ELEMENTARY, MIDDLE, OR HIGH? FREE OR REDUCED LUNCH % # OF STUDENTS LINK TO SARC 7Adobe InDesign CC 14.0 (Macintosh) Adobe PDF Library 15.0