iLC Consulting Application

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District or School Name (if applicable) :
*Lead Contact:
*Why are you requesting consulting services for Blended Learning?:
Current state of Blended Learning:
What's your desired outcome?:
Are there other district/school initiatives that might support/conflict with Blended Learning? If so, please describe.:
Technology Leadership:
Curriculum/Instruction Leadership:
District Leadership:
School Leadership:
Others that would be involved in the consulting engagement:
*How did you hear about us?:
Please specify if you answered event or referral:

*I agree to iLC's Terms and Conditions
Yes, I agree