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Applicant Forms
Form
#
Description
USAC Forms
Various
USAC/SLD Forms:
470, 471, 479, 486, 500 & 472
IRS W-9 Form
W-9
IRS W-9 Taxpayer Identification Number
Income Survey
Fall 2010
Distribute to students starting Spring 2010 through Fall 2010. Survey can be used to determine your school's E-Rate discount using the Alternative Discount Method.
Survey Summary
Nov 2010
If you use the Household Income Survey, use this form to summarize your results.
Board Items
Jun10
Items to discuss at your June/July 2010 Board Meeting
CIPA Certification
June 2010
KSLLC Clients: Use this form to certify compliance with the Children's Internet Protection Act, including a cyberbullying awareness curriculum declaration.
Contact Update
Jul10
KSLLC Clients: Use this form to send us contact information for your school or library
USAC Equip Transfer
Ongoing
Notification Form for Equipment Transfers. Use this form if you move E-Rate funded equipment within the 3 year non-transfer period.
Service Provider Change Request Form
Ongoing
KSLLC Clients: Use this form to notify us that you would like to change service providers (vendors)
Service Substitution Request (SSR) Form
Ongoing
KSLLC Clients: Use this form to notify us that you would like to change products and services on your existing E-Rate funding.
Server Allocation
Sep 2010
KSLLC Clients: Use this form to specify the eligible use of servers and supporting server items requested for FY 2011-12. Also used to report usage of existing servers for which basic maintenance is being requested.
Basic Mtc Detail
Sep 2010
KSLLC Clients: Optional form to provide us with your list of equipment for maintenance.
E-Rate Discount
Nov 2010
KSLLC Client Schools: Low Income and Enrollment information needed to establish your E-Rate discount.
Accepted Bids Y14
Dec 2010
KSLLC Clients: Use this form to list your accepted bids for 2011-12.
Bid Scoring
Dec 2010
KSLLC Clients: Use this form to score your bids for E-Rate 2011-12.
© 2010 Kellogg & Sovereign Consulting, LLC
1101 Stadium Drive
Ada, OK 74820
Phone: (580) 332-1444
Fax: (580) 332-2532
Email:
info@kelloggllc.com