Reserve Qwizdom Student Response System

Page 1 of 1     Reserve Qwizdom Student Response System   The Watson School of Education has a variable size Qwizdom response system that can be used by less than ten or up to 100 at the same time. To reserve this system simply fill out the form below. This form must be filled out at least 24 hours before you will need the Qwizdom set. If you have an emergency and need the set immediately or have questions about checkout contact Alex Theodoropoulos at 962-7248 or Candace Blanke at 910-962-3900.   1. Your Name*       2. Your Phone Number*       3. Your Email Address*       4. Course Title*       5. Room number where the Qwizdom set is needed*       6. Date Needed* The value must be between 04/01/2007 and 04/01/2015, inclusive.   mm/dd/yyyy     7. Start Time* Be sure to specify A.M. or P.M.       8. End Time* Be sure to specify A.M. or P.M.       9. Number of item needed.* Please list the number needed in parenthesis, i.e. 30 Remotes. This number should match the number of students or participants you wish to use the set with.       10. Would you like assistance in setting up and/or putting away the equipment?*   --Please Select--Yes No     11. Course(s) Impact* Please list the course(s) that this technology will impact       12. Student Impact* Please list the number of students that this technology will impact.       13. Additional Comments or Questions

For more information about the Watson School of Education, please contact us at (910) 962-3807