Technology Requests

This form is to be used by teachers and/or staff members of the School District of Shiocton to request the purchase of technology - hardware (equipment) or software (computer programs).  Submission of a request does not imply approval.  Approval will be communicated to the requesting individual separately.

Complete this form, making sure to enter information in the required fields (*).  Click on the send button to submit the request. 

Teacher / Staff Member Technology Request Form:

Teacher / Staff Member Technology Request Form

Name of the individual submitting the request:


School / Grade / Department:


Technology item(s) being requested (please include quantity and any details available).


Estimated cost for the requested technology.


What source of funding is being proposed for the requested technology?

(1 required)
Department/Classroom Budget
  Building Principal's Budget
District Technology Budget
  Grants / Alternative Funds
Other (explanation required)

When does the technology requested need to be available for use?


Who will be using this equipment?

(1 required)

How will the technology requested support the teaching and learning process?  Include targeted standards if appropriate.


What type of training will be needed for the successful implementation of this technology?


Is there a need for maintenance work to accomodate the technology?  For example, will additional electrical drops, data drops, furniture construction, etc. be required.  If yes, describe the work needed in the space below.


If yes, enter below.


What is the plan for ongoing expenses such as maintenance, repair, replacement, or consumable supplies?

Please include any additional comments that would be helpful in the approval process.

* Enter Your Email Address:

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  • School District of Shiocton
  • N5650 Broad Street PO Box 68, Shiocton, WI 54170
  • Phone: (920) 986 - 3351 | Fax: (920) 986 - 3291
  • Email