Faculty Instructional Technology Request

Section 1: Position Information

Name: *

Email: *

Name of technology service or tool you are requesting: *

Name of vendor/company: *

Cost: * 🛈

Per month or per year? *

Purchase method:
The college can requisition this purchase on a college credit card and send you the necessary information for access. Or, if approved, you can make the purchase with a personal credit card (or other method) and complete an expense reimbursement form. Please mark one choice below so we know how to proceed. *

Requisition by Instruction

Reimbursement

Academic use:
How does this tool or service enhance your teaching? *

Additional comments:

You will receive confirmation if your request is approved or denied. If approved, the form will be forwarded to the Instruction Department to create a requisition for purchase (if selected above). A staff member will contact you once that process is complete.

Is this form ready to submit?

Yes

Section 2: Instruction Approval

Approved

Rejected

Date +

Comments

Ready to submit to IT?

Yes

Section 3: Technology Approval

Approved

Rejected

Date +

Comments

Is this form ready to submit (final)?

Yes