Date:
Name: Building: Choose Building CCHS Coesse ISMS Little Turtle Mary Raber Marshall Northern Heights Room Number:
Describe the type of software
Number of licenses needed:
Vendor Name and Address:
Cost: $
How was the need determined? How was the software selected? Who was involved?:
Describe how this software will be used:
List the curriculum standards the software supports:
Give a brief description of the functionality of this software:
Describe how you are going to use the software and the expected outcomes:
How is the success of this software going to be measured?
List the training issues:
Signature of Person Requesting software: _________________________________ Date: _____________
Approved by Supervisor/Principal: Yes No
Signature of Supervisor/Principal: ________________________________________ Date: _____________
Approved by Assistant Superintendent: Yes No
Signature of Assistant Superintendent: ____________________________________ Date: _____________
Approved by Technology Director: Yes No
Signature of Technology Director: ________________________________________ Date: _____________
When complete print this page
