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IntelliTools Product Registration

* Items are Required

*	Name:
	Title:
	School/Org:
	District:
*	Address:
*	City:
*	State:	*Zip:
*	Country:
	Phone:
	Fax:
*	Email:

Yes! Please contact me about special promotions!

I Work At:
a school a district office other

I Purchase Software for:
a student a classroom a school
a district homeschool library

Hardware I use: (select all that apply)

Mac		PC
MacOS		OS

IntelliTools Products Used:

IntelliPics®	IntelliTalk®
IntelliPics® Studio	IntelliTalk® II
IntelliPics® Studio 3	IntelliTalk® 3
IntelliMathics	Balanced Literacy
IntelliMathics 3	Overlay Maker®
MathPad	Number Concepts 1
MathPad Plus	Number Concepts 2
IntelliKeys®	ClickIt!®
ReadyMade Curriculum Activities

My Area of Specialization is:

Regular Ed	Curriculum Director
Technology Director	Computer Lab Coordinator
Reading Specialist	Math Specialist
Title 1 Teacher	Special Ed
Technology Specialist	Occupational Therapy
Speech/Language	Adaptive Technology
Visual Impairment	Rehabilitation

My Organization Makes Technology Purchases from:

Jan - Mar	Jul - Sept
Apr - Jun	Oct - Dec

My Annual Budget for Technology Purchases is:

up to $1000	up to $10,000
up to $25,000	over $25,000

Grade Levels Served:

Infant/Toddler	Middle School
Preschool	High School
Elementary School	Adults

I Prefer Network Versions of Products When Available:

yes

If yes, what type of Network do you have?

Who makes technology/software purchases for your school or district?

	Name:
	Title:
	School/Org:
	District:
	Address:
	City:
	State:	Zip:
	Phone:
	Fax:

Product Name	Quantity Purchased:
*
Version	Purchase Date

Serial Number (if product is IntelliKeys)

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