Systems Design New Installation Form
School District Name
*
County-District Number
*
TDA Contracting Number
*
Street Address
*
City
*
State
*
Zip Code
*
Name of Installation Contact
*
Installation Contact's Phone Number
*
-
Area Code
Phone Number
Installation Contact's Email
*
example@example.com
Name of Child Nutrition Director
*
Child Nutrition Directors Phone Number
*
-
Area Code
Phone Number
Child Nutrition Directors Email
*
example@example.com
Name/Contact to Appear on State Reimbursement Claim
*
We are a CEP district
*
Yes
No
We are a Provision 2 District
*
Yes
No
Name/Contact to Appear on Benefits Letters
Name/Contact Information of Hearing Official and Title
Tell Us About Your CEP Campuses
All Campuses Are CEP
Not All Campuses Are CEP
Name/Contact Information of Technology Director
Please List All Campuses and Campus Numbers
All Campus Listed Above are Severe Need
Yes
No
List All Campuses that are Severe Need
Static IP Address Assigned to the Food Service Server
*
Network Subnet Mask
*
Gateway IP Address for Server
*
Indicate the Type of Remote Connection to be used
*
Secure Shell
VPN (Cisco, Microsoft, Other)
Telnet or Other Internet Connection
Static IP Address for the Main POS System Printer
*
The Point of Sale Terminals Will Have IP Addresses That Are
*
Assigned Dynamically
Use static IP addresses
List of Campuses and IP Addresses Equal to the Number of POS Terminals at Each Campus
Static IP Addresses for the Campus Printers
*
Does Your District Serve Breakfast in the Classroom
Yes
No
Do You Plan to Use ID Cards
Yes
No
Please Select and Upload the District Logo
Browse Files
Cancel
of
Does Your District Serve After School Snacks
Yes
No
Will You Elect to Display the Student's Picture on the Touchscreen
Yes
No
Your Desired Install Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Your Comments or Questions
Send The Install Information
Should be Empty: