STEM Lab Facilities ReadinessIntake Form Fill out the form below. Let’s get started! Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.School Name: * Wi-Fi port levels Room Number or Lab Name: *Point of Contact: ( Email) *Point of Contact ( Name): *Grade Levels Served: ( enter the grade levels below) *Estimated Number of Students per Class *How many electrical wall outlets are in the room? *Are outlets grounded and meet code requirements? *Is there a dedicated circuit for equipment like 3D printers? (Yes/No)Are additional power strips or surge protectors needed?Wi-Fi available in the room?YesNoIs the Wi-Fi signal strong and stable?YesNoIs there a hardwired Ethernet port available? YesNoAny known firewall or device access restrictions?Submit