Armenia school connectivity programs mobile lab project application form

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Region Information
PARTICIPATING GOVERNMENT ADMINISTRATION AGREEMENT

ARMENIA SCHOOL CONNECTIVITY PROGRAMS

MOBILE LAB PROJECT APPLICATION FORM

Region: _______________________________________________________________________ Governor: Name: ________________________________________________________________________ Regional Government Administration Address: _______________________________________ Work tel. (with city code): ____________________________________ Fax:______________ E-mail: __________________________ Head of Education Department: Name:_________________________________________________________________________ Work tel. (with city code): ____________________________________ Fax: ________________ E-mail: __________________________
Region Information
Total Population for the Region _____________
Number of cities/towns: ____________________	# of secondary schools in cities/towns__________
Number of villages: ______________________	# of secondary schools in villages: ____________

Is the Region actively involved in any special programs?
 Ministry of Education program (describe)________________________________________

_____________________________________________________________________________

 US Government program (describe)_____________________________________________

_____________________________________________________________________________  Diaspora describe)__________________________________________________________

_____________________________________________________________________________

 Other (describe)_____________________________________________________________

Statement Of Interest
1. Please describe your vision for participating in the Mobile Lab Project in your region.

(We encourage you to gather input from schools participating in the AC2K/AmSCP)

2. If your Marz is selected, how will the Mobile Lab help the students meet their needs and interests?

3. Please state three concrete ways how the teachers will be able to use the opportunities offered by the project in their teaching activities.

4. How do you plan to motivate users/beneficiaries to use the Mobile Lab? (Both in an educational and broader context)

5. How can technology benefit community?

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(ËÝ¹ñíáõÙ ¿ Éñ³óÝ»É ïå³ï³é»ñáí)

PARTICIPATING GOVERNMENT ADMINISTRATION AGREEMENT

W
region name

e, as _____________________________ regional officials are prepared to fulfill the responsibilities and commitments outlined below, regarding the Mobile Lab project:

Actively provide security for the Mobile Lab

Offer Mobile Lab candidates for interview and selection by Project.

Enable school participation by supporting students, teachers and administrators in AmSCP activities

Continually promote community participation

Promote the project with the aim of creating a stronger, healthier community through education, civic participation, and community involvement

We do hereby endorse the region’s participation in the Mobile Lab project:

Region Date of submission

Governor (Please print) Signature of Governor

Head of Education Department Signature of Head of Education

Armenia School Connectivity Programs are programs of the US Department of State, Bureau of Educational and Cultural Affairs, funded through the FREEDOM Support Act and implemented by Project Harmony.

Armenia, Yerevan, 375028, 45 Sevastopolian St. Tel: 26-06-86, 26-06-87

Website: www.projectharmony.am E-mail: ph@projectharmony.am

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Armenia school connectivity programs mobile lab project application form

Region Information

ä²ÚØ²Ü²¶Æð Ø²êÜ²ÎÆò Ø²ð¼äºî²ð²ÜÆ ºì ÎðÂàôÂÚ²Ü àô ¶ÆîàôÂÚ²Ü ì²ðâàôÂÚ²Ü Ðºî

PARTICIPATING GOVERNMENT ADMINISTRATION AGREEMENT