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Application for mimio Education Pricing
(for Education Institutions in USA only)

To apply online, please complete the form below and press "Submit". After selecting "Submit", you will have the option of printing a copy of your submission for your records. Note: fields marked with an asterisk (*) below are required information.

School Information
*School:

  School District:

*Address 1:

  Address 2:

*City:

*State:

*Postal Code:

*Country:


Contact Information
*First Name:

*Last Name:

  Title:

*Email:

*Phone:


Reseller/Consultant Information (optional)
  Reseller/Consultant Name:

  Address:

  City:

  State:

  Postal Code:

Country:


  Contact Name:

  Email:

  Phone:


To locate a local authorized reseller, please check listings for your state at http://www.mimio.com/buy/resellers.php or call us at 877.696.4646

*Please tell us how you heard about mimio
  products:

*Have you attended an Online Demo?
      Yes     No

If yes, when?:
     less than 30 days ago
     31 - 60 days ago
     61 - 90 days ago
     90+ days ago

*Products:
Please check the product(s) you are interested
in purchasing and enter quantity.

Save up to $50 when purchasing a mimio Pad with a mimio Interactive or a mimio Interactive + Capture.

Products:		Quantity:
	mimio Interactive (P/N 600-0045)
	mimio Interactive + Capture (P/N 600-0050)
	mimio Board 80 (P/N 1741992)
	mimio Board 100 (P/N 1741993)
	mimio Board HD 90 (P/N 1741994)
	mimio Board HD 110 (P/N 1741995)
	mimio Xi Classic Trade-in Kit (P/N 590-0011)

Accessories for mimio Interactive:
	mimio Wireless Upgrade Kit (P/N 610-0021)
	mimio Carry Case (P/N 610-0020)
	Additional mounting brackets (3M)
	1 pack (P/N 850-0031) 5 pack (P/N 850-0040)
	Additional mounting brackets (magnetic)
	1 pack (P/N 850-0056) 5 pack (P/N 850-0057)

Accessories for mimio Board:
	mimio Board Rolling Stand** (P/N 610-0054)
** only supported for mimio Board 80 and mimio Board HD 90.

Accessories for all products:
	mimio Mouse Stylus (P/N 850-0055)
	mimio Capture Kit* (P/N 580-0014)
	mimio Projector - Folding Wall Mount (P/N 1751202)
	mimio Projector - Folding Wall Mount w/Speakers and I/O Module (P/N 1751204)
	mimio Projector - Fixed Wall Mount (P/N 1751205)
	mimio Pad (P/N 1747666)
* Requires a mimio Interactive or mimio Board, sold separately.

*Operating System:
     Windows
     Macintosh
     Both (Win/Mac)

*Expected Purchase Date:
     less than 30 days
     31 - 60 days
     61 - 90 days
     90+ days

Statement of Terms
Please read the following statement before submitting and agree to its terms.

I represent that this application has been written solely by me and not copied by any other source or person. I understand that mimio may use the described plan for integration of mimio in my classroom in any manner it desires with no compensation and obligation of confidentiality to me. mimio shall not be liable for any use or disclosure of my mimio Grant pricing submission by me.

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