CKCIE Equipment Request

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This form is to be used for requesting equipment from CKCIE for staff use. This is for equipment that is extra or non-standard issue. All equipment requests will be considered based on availability and need. Any approved equipment requests are not guaranteed year to year.

Request Type *

First Name *

Last Name *

Email Address *

Location *

Who will be using the equipment? *

Position of person using the equipment *

Who is your SPED Coordinator/Supervisor? *

What equipment are you requesting? *

Reason for equipment request *

Please be specific about the need

How long will you need the requested equipment for? *

Up to a week(indicate dates below)

Up to a month(indicate dates below)

Current School Year

Start Date for equipment requested *

YYYY

End Date for equipment requested

YYYY

Submit

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