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          Software and Hardware Request Form

 

Your Name           Today's Date  

Phone Extension            Building 

Please list all proposed locations and computers for requested software/hardware below:

I am requesting the software/hardware to be installed

If a Building or District Request:  Cost Per Unit   # of Units Requested

 

Room Number(s)            Computer #/Name   (ex. 315a, 315b, 315c)

Requested Software is            Number of Licenses Owned/Requested  

Description/Title of Product 

System Requirements (operating system, disk space required, RAM, video and audio requirements)

Number of students to be served 

 

VENDOR INFORMATION:

Company & Contact Name

Address

Phone Number Fax Number

 

If this is a software request, I agree to provide copies of all licenses to the Building Technology Assistant to be kept on file for the duration that this software is installed on district systems.


Signature of Originator (Type Full Name)  
  (this will be used as my on-line signature for this form only.  By submitting this form, I agree to abide by all district requirements.)

 

Building Priority Level (to be completed by building originator)