Technology Request Form
Fill out the following form to request equipment or services from IT. Faculty and Staff should note that if a technology error is impacting immediate instruction or preventing you from completing your work, please contact IT immediately.

Please note: the Dean of Information Services has final approval over all requests per Policy 1111, Procedure 2112 (http://docs.bartonccc.edu/procedures/2112-itpurchases.pdf ).

Supervisor Email *
Requester Name *
Please provide your first and last name.
Your answer
Requester Email *
Your answer
Requester Phone Number *
Your answer
Title of IT Request *
What item or service are you requesting from IT? You may input further details later in this form.
Your answer
What is the intended use or objective for this request? *
Your answer
What is the estimated time of completion for this request? *
When would you like to see this project completed by?
MM
/
DD
/
YYYY
Will this request impact students? *
If answered yes, the next page will allow you to explain how your request will impact student learning.
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