Eskwela Appform_3aug2009

DATE RECEIVED BY CICT:

APPLICATION FORM

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Please indicate (mark with an “x) the organization initiating the set-up of an eSkwela Center: DepED LGU NGO Civic Org If DepED initiated, please indicate the following:

If Non-DepED initiated, please indicate the following:

Region ALS Division, District Location of potential site (please indicate exact address Name of Organization Location of proposed site (please indicate exact address)      

Target Date of eSkwela Operations:

Other

                 

Contact Person (for eSkwela setup and this form)

           

If other, please specify: Name Position Office / Organization

                 

Telephone

     

Email

     

     

AVAILABILITY OF INFRASTRUCTURE REQUIREMENTS

Space/Room      

Target Number of OSYAs for first batch of eSkwela learners: Schedule of eSkwela sessions (Please mark planned operating hours and days with an “X”) M T W Th F Sat AM 8:00 – 9:00 9:00 – 10:00 10:00 – 11:00 11:00 – 12:00 PM 1:00 – 2:00 2:00 – 3:00 3:00 – 4:00 4:00 – 5:00 5:00 – 6:00 6:00 – 7:00 7:00 – 8:00 8:00 – 9:00

Computers

Yes

How many?       Computer Specs - General

No

*Please provide pictures of the proposed site (interior and exterior), computers and equipment (if already available) by attaching it to this form (if RAF will be sent via courier) or via email ( [email protected] ) Airconditioning Tables and Specifications Room Size Electricity Units Chairs

Sun

Required

Actual (please indicate actual specs)

At least 1.5 sqm per computer, with provision for work area

     

Internet

Yes

If yes, indicate service provider:

     

electric outlets should be enough for number of computers and Center equipment; separate circuit breakers for computers and aircon units

     

No

If yes, what type (mark x) If Broadband, What speed?

3-10 computers: 1 aircon (2 horsepower) 11 computers or more: 2 aircon units (2 horsepower)

     

Dial-up

one set (computer table and chair) per computer, plus 2 additional sets for Center Manager and Learning Facilitator

     

DSL / Broadband      

Yes

No

Do the computers run on Windows? (if yes, please indicate version – Windows 98, 2000, XP or Vista) Can you play audio (CDs, mp3s) in the computers? Can you play video (VCDs, DVDs) in the computers? Are the computer units networked? (with LAN cables or wireless)

Computer Specs - Detailed You may ask the resident IT/computer expert in your office (Network Administrator, MIS, programmer):

Technical Specs

How many computer units?

Performance Processor

1 server PC

2.4 GHZ & higher

Memory

Internet / Network Ready

Multimedia Capability Hard Disk

Sound Card

Video Card

2 GB

160 GB (w/ <10 GB free space)

Any, working

Higher than 1024 x 768 resolution

Any, working

Monitor

Headset

LAN Card

LCD

Any, working

10/100 Mbps

Higher than 1024 x 768 resolution

LCD

Any, working (1 headset per computer)

10/100 Mbps

Recommended

Software* Operating System Any licensed / open source operating system Any licensed / open source operating system Any licensed / open source operating system Any licensed / open source operating system

Applications licensed / open souce applications

20 workstation PCs

900 MHZ or equivalent

512 MB

80 GB (w/ <10 GB free space)

1 server PC

900 MHZ or equivalent

1 GB

80 GB (w/ 10 GB free space)

Any, working

1024 x 768 resolution

CRT

Any, working

10/100 Mbps

4 computer units (including server)

500 MHZ or equivalent

256 MB

40 GB (w/ 10 GB free space)

Any, working

1024 x 768 resolution

CRT

Any, working (1 headset per computer)

10/100 Mbps

     

     

     

     

     

     

     

     

     

     

      workstation PCs (indicate how many)

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

Minimum

licensed / open souce applications licensed / open souce applications licensed / open souce applications

1 server PC

Actual (please indicate actual computer specs here; use extra rows if needed)

* (please send photos of license stickers of proprietary operating system/applications; on a separate sheet, please also indicate license/serial number/s of OS/applications. Please send photos and license/serial number list to [email protected])

AVAILABILITY OF STAFF REQUIREMENTS Center Manager Name Office / Organization Please indicate relevant experience (educational background, work

                 

Network Administrator                  

experience, training)

Learning Facilitators      

How Many?

Relevant Experience (yes or no) Position / Designation

Trained in ALS? (If Yes, please indicate date of training)

Computer user? / Does he make use of the computer for routinary tasks (e.g. reports, letters, etc)?

Does he/she make use of the Internet (e.g. e-mail, browsing, chat)?

1.     

     

     

     

     

2.     

     

     

     

     

3.     

     

     

     

     

4.     

     

     

     

     

5.     

     

     

     

     

Name

Community Involvement Please indicate (mark with an “X”) the involvement of your community in the implementation of eSkwela (please specify for NGO, Civic Org, or Other):

DepED

LGU

NGO

Civic Org

                                               

Provision of Space/Room for eSkwela Renovation of space/room (if needed) Electricity Internet Airconditioning Units Headsets Computer Tables and Chairs Supplies (print modules – for modules where eSkwela e-modules are not yet available; materials for learner portfolio) Computers License for OS (if proprietary; i.e. Windows) Repair and Maintenance of computers Center Manager, salary Network Administrator, salary Learning Facilitators, salary Accomplished by: (Name & Signature)

     

Position/ Designation:

           

Contact Number/s: E-mail Address:

Other

How can eSkwela, as a project, serve your organization, your community and its out-ofschool youth and adults?      

                                    Noted by:

     

(Name & Signature of Immediate Superior / Head of Organization)

     

Position/ Designation: Contact Number/s: E-mail Address:

                  revised as of 3 August 2009