Textbook Request
Request Details
Date Requested:

Requesting Administrator

1. Requesting Administrator
Username:
Name:
First
Last
Email:
School/Dept.:

Requested Textbook

2. Requested Textbook
Title:
Textbook Format:

What format is the textbook?

Company:
ISBN (Teacher Edition):
ISBN (Student Edition):
Number of Teacher Copies:
Number of Student Copies:
Total Cost of Requested Textbooks:
Attach Quote:

Textbook Usage

3. Textbook Usage
Course Name:

Justification for Request

4. Justification for Request
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Justification Selection

– Teacher Name:

Approval of Request

Approval of Request
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If declined, please select a reason:

Reason for Declining Request

Order Status

Purchase Order
Date:
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