Requestor Email:

Requestor Title:

VC/Presidents' Email:

Center of Excellence:

Department:

Dean Email:

Prog. Director/Coord. Email:

1. Upon submission, the listed President will receive notification for approval.  Director and Dean will also be notified but have read-only access.

2. Email address entries will be validated against AD to ensure accuracy of spelling.

List the Course(s) that will utilize the equipment:

How will this purchase be utilized to address the Student Performance and/or improve Access & Equity as listed in the Perkins V, Comprehensive Local Needs Assessment (CLNA).

Provide the latest labor market/vitality demand for this program.  You may list up to 5 Careers and their projected growth. (See EMSI database)

List all relevant industry certifications/accreditations affected by purchase:

Can other programs utilize this equipment at your campus?

If yes, please list programs:

Click the + sign below to add your entries.

Click the + sign below to add your entries.

(Max Characters:  1000)

(Max Characters:  1000)

(Max Characters:  1000)

(Max Characters:  1000)

List Workforce Program(s) affected by your request, number of students in the program(s), and the degree type:

Ext. 85299 and 88678

For questions regarding this grant request, contact the Perkins Administrative Office