Antwerp Local School District Instructional Resource Request Form
This form should be completed by the teacher prior to completing a requisition. Once submitted the requisition will go to your Building Principal for approval or discussion.
Teacher(s) making request: *
Your answer
Date Requested: *
MM
/
DD
/
YYYY
Building: *
Type of Resource: *
Required
Resource description: Please describe what you are asking the district to purchase (vendor, licenses/copies needed, support needed, etc.) *
Your answer
Estimated cost: *
Your answer
Funding source, if known. *
Your answer
Provide a summary of why the resource is being requested, including how it will support or extend instruction within the context of your content standards and how it will impact student achievement. *
Your answer
How did you determine that this resource will meet your needs? *
Your answer
How will you evaluate the impact on student achievement? *
Your answer
Please explain how current resources do not meet your instructional needs. *
Your answer
Indicate the estimated percentage of time this resource will be used. *
Your answer
Is this a resource that can be shared with other classrooms? *
Submit
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