HARDWARE REQUEST FORM

Please note that you must have approval from your Department PRIOR to filling out this form.

Faculty/staff monitor purchases for telecommuting will not be approved. If the purchase is not a monitor replacement for an office on campus, only monitors purchased with external funding (i.e. grants) will be approved.

Please note that the approved monitor request from the college is a single 24" monitor.

First Name *

Last Name *

Email Address *

Campus Building and Room Number

Is this an upgrade or replacement for a component in an exisiting machine? *

Yes No

If this is an upgrade or replacement, please provide the model number and serial number or service tag of the exisiting hardware.

(model number and serial number or service tag)

Departmental Approval *

Yes No

I acknowledge that I have obtained Departmental Approval for the hardware I am requesting via this form.

Department Chair/Program Director Email Address *

Are the index and account new? *

Yes No

Index

Account *

Please describe what equipment/parts are necessary. Please provide the narrative for each item being ordered. *

Please indicate how many are needed.

Would you like consultation on your purchase? *

Yes No

Upload

If you have documentation in regards to your request, system specifications, quotes, etc. You may upload it here.

Additional Upload 1

Additional Upload 2