Format for Local EDP Request

(Format for Local EDP request)
MICROCOMPUTER EDP REQUEST
Southern Polytechnic State University

Department __________________________________________ Date ____________________

Individual Responsible for Equipment/Software _________________________________________

Phone ______________ Equipment/Software location __________________________________

Primary Use of Requested Equipment/Software:

(Check one) ______Administrative ______Instructional ______Research ______Service

Computing Equipment/Software Requested:

____________________________________________________________________________

____________________________________________________________________________
(Use attachment if necessary.)

Estimated Cost of Equipment/Software: ______________________________________________

Funding Source:
(Check all that apply) ______State ______Grant ______Service ______Income ______Contract

Data Communications/Networking:
Will the equipment be connected to the campus network? ______Yes ______No
Will the equipment be connected to a LAN? ______Yes ______No

Make sure departmental request is attached and contains all signatures. When approved departmental request will be forwarded to Procurement for purchasing.

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Institutional Approval Number _____________________ Approval Date: ___________________

Signatures:

____________________________________________________________________________
(ACIT Representative)

____________________________________________________________________________
(Additional approvals needed for non-standard items)