Technology Request

Person Making Request:
E-mail Address:
Location of Use/Installation:
Room ID/Office:

Requested Technology Equipment
Item #/Description:
Make:
Model No:
Web link to view item (if applicable):
Vendor/HCBOE Warehouse:
Contact Name:
Phone Number:
Has the county previously purchased the equipment (to your knowledge)? Yes No
If 'Yes', where is it being used?

Specific Details of Request
If specifically requesting to purchace equipment, explain how it will be utilized