Universal Service: Pennsylvania
Survey Form
Preparation for Universal Service Discount Applications

Please supply the following information to identify yourself: 
 
Name:    (Last)   (First) 

E-mail:         

Organization:   

City:                State:

Please answer each question by selecting one or more of the checkboxes provided or typing in requested information.

1. Has your school, school district or library developed a technology plan? 

	 yes
	 no
2. If your school, school district or library has developed a technology plan, has it been reviewed with an eye toward its use as part of a Universal Service discount application? 
	 yes
	 yes - approved for other federal programs
	 no
	 no technology plan
3. Has your school, school district or library conducted a technology inventory? 
	 yes
	 no
4. Has your school, school district or library joined a consortium to seek telecommunications services at prices below standard tariffed rates? 
	 yes
	 no
5. If your organization is part of a consortium, what groups are included in the consortium? 
	 schools
	 school districts
	 libraries
	 rural health care providers
	 non-eligible entities
6. Where does your school, school district or library go for technical advice in the implementation of its networking plans? 
	 in-house expertise
	 other school districts
	 regional service center
	 online resources
	 local university
	 consultant
	 vendor
7. Please list any other comments you have with respect to preparations for the Universal Service discount program.


       Thanks for participating!
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