Fillable Printable IT Service Request Form - Florida Keys Community College

IT Service Request Form - Florida Keys Community College

INFORMATION TEC HNOLOGY REQUEST FORM

Name:____________________ Department:_____________________________

Description/Justification for the Request

_______________________________________________________________________

Estimate Total Cost:

Recurring: $_______________________

Non-recurring: $_______________________

Item (indicate quantity)

Audio Visual

Computer (indicate desktop/laptop)

Network Drop

Other (describe in detail)

Power Outlet

Security

Software

Telephone

Attach Technical Specifications, if applicable.

Accessories

Desks

Tables

Misc.

Other Furniture

Questions/Considerations:

1. How does this request fit into the mission, vision and long-range plans of the college?

(Consider your department and the college as a whole. Include strategic goal/objective this

request supports).

2. Does this request address a current need in your program? If yes, what?

3. How will this request impact the educational (teaching & learning) process?

4. Is this request necessary for your program to maintain academic quality and credibility?

Describe use.

5. Will additional staffing or training be required for your department?

6. Indicate source of support. Consider staff time, resources, etc.

In-house (Obtain signature of Director, TSS)___________________________

Service Contract (Indicate vendor/sub-contractor)_______________________

7. Can this request be combined with any other requests or resources? Does it service any other

department on campus? How many departments/programs would this request impact?

8. What other alternatives/options are available to your department if this request does not go

forward? Is this the most cost effective solution for your department and the college?

9. Estimated the life of this equipment before significant updates or changes need to be made.

10. What is the return on investment? Include any measurable data.

Worksheet Items

1. List any additional , materials or supplies that will be needed on an on-going basis (i.e., toner,

paper, projector bulbs, etc)

2. Will there be any additional staffing requirements for this request? Yes or No

If yes, explain and note whether these will be full, part-time or work study positions.

If yes, list any additional equipment or supplies needed for this position (i.e., computer, desk,

office, etc.)

3. Do you already have funds identified for this request (i.e., department funds, grants, gifts,

etc.)? Yes or No

If yes, list how much and from what source