Technology Budget Request Form

First Name:

Last Name:

Email (to receive a copy):

Verify E-mail:

Department:

4-digit Department Number:

Describe specific items and features of equipment requested:

Computer Equipment:

Printers:

Software:

AV/TV:

Question 1 (REQUIRED): What specific academic/administrative need or requirement will be met by this request?:

Question 2 (REQUIRED): How is this need or requirement being met now?:

Note any specific hardware/software requirements and why they are required (e.g. buy only from specific vendor, model numbers, etc.):

If known, estimate all one time costs other than hardware(explain any indirect costs such as training books, installation, communications devices, new power requirements, etc.):

If known, estimate new recurring costs (e.g. maintenance, upgrades, communications, etc.):

Funding Source:

Grants:

Restricted Funds:

Other (describe):

Submit