Equipment Purchase Request Form - Center for Immersive Learning and Digital Innovation

Request to purchase new equipment for JHSON Simulation Instructional Needs

(Please fill out one form for each equipment)

Email(Required)

Course Name(Required)

Course Number(Required)

Name of the Equipment Needed(Required)

Elaborate on the justification for this equipment(Required)

If yes, which committee? If not, what are your plans to obtain approval?(Required)

Directors? If yes, which committee? If not, what are your plans to obtain approval?(Required)

When will this equipment be used?(Required)

How many items of this equipment will you need?(Required)

How many times will it be used in a semester and in a year?(Required)

Is this equipment for a short-term event or is this for a long-term goal?(Required)

Where do you anticipate this equipment will be stored?(Required)

Do you have any vendor preference? (Provide 3 vendor names if possible)(Required)

What is the estimated cost for this equipment?(Required)

Do you have a budget number for the purchase or would you like the CILDI budget to support this purchase?(Required)

Do you have any other comments that will help us with the purchase of this equipment?

Equipment Purchase Request Form – Center for Immersive Learning and Digital Innovation