Curriculum Materials Request Form printable pdf download

Curriculum Materials Request Form

Curriculum materials Request Form

This form must be completed by the faculty member and submitted to the Dean or related committee

for approval.

Date of Request: _____________

Name ________________________________________________

Email ____________________________________ Phone________________________________

This request is for : (Select only one for each form)

Reference Book ____ Textbook _____ Equipment _____ Software ____ Other _______

Complete description & amounts of items needed:

_____________________________________________________________________________________

Briefly explain the purpose of this Request

_____________________________________________________________________________________

Estimated cost: __________

Dean/Committee approval _________ _____________________________________Date: _________

--------------------------------------------- Below to be filled out by Chicago office ------------------------------

Date received ________

Items are approved: yes ___ no ____

Approval by: _________________________________________________ Date: ______________

Items ordered date: ____________________ Ordered by: __________________

Cost: _________________ Name of Vendor ____________

Curriculum Materials Request Form