Textbook Request
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Instance Number
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Request Details
Date Requested:
Requesting Administrator
1. Requesting Administrator
Username:
Username
Confirm
i
Name:
First
First Name
Last
Last Name
Email:
Email
School/Dept.:
School or Department
Requested Textbook
2. Requested Textbook
Title:
Book Title
Textbook Format:
What format is the textbook?
Digital
Hardback
Company:
Company
ISBN (Teacher Edition):
Teacher Edition ISBN
ISBN (Student Edition):
Student Edition ISBN
Number of Teacher Copies:
Number of Teacher Copies
Number of Student Copies:
Number of Student Copies
Total Cost of Requested Textbooks:
Total Cost of Requested Textbooks
Attach Quote:
Attach
Delete
Textbook Usage
3. Textbook Usage
Course Name:
Course Name
Justification for Request
4. Justification for Request
Select one:
Justification Selection
Increased Student Enrollment
Requested by Teacher
– Teacher Name:
Name of Teacher Requesting Textbooks
New Course Added
Other:
What is the justification?
Submit
No description
Approval of Request
Approval of Request
Select one:
Approved
Declined
Selection
If declined, please select a reason:
Reason for Declining Request
Consumable
Funding
Non-Adoption Year
Other:
What is the reason for declining this request?
Submit
No description
Order Status
Purchase Order
Attach PO
Delete PO
Date:
Submit
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