Name	*
Telephone	*
Email	*
Summer Contact Information	[Phone, email] *
Course Name / Course Number / Sections	*
Semester / Block / Term	*
Date Needed	*
Expiration Date	*
Do you have the software with the textbook?	YesNo  *
Title/Version	*

What software is needed with this class?*
(Fill in software title and version, and check New or Upgrade - If this is pre-existing network software mark "Network" in version)

Title:		New Upgrade
Version:

Where is software needed?*

	Professor's Office / Department / Division
	Smart Classrooms
Computer Labs
	Athletic Center - McHie Lab (McHie 100)
	Benner - Library Lab (Benner 011)
	Benner - Learning Resource Center (Benner 006)
	Benner - Faculty Staff Training Lab (Benner 027)
	Benner - Comm / Art Computer Classroom (2nd Floor)
	Benner - Multimedia Lab (2nd Floor)
	Burke - CSIS Lab (Burke 302)
	Burke - English Department #1 (Burke 402)
	Burke - English Department #2 (Burke 408)
	Burke - English Department #3 (Burke 410)
	CRC - Graduate School Lab
	Larsen - Music Department (Larsen 134)
	Larsen - Art Department (Larsen 005)
	Parrott - Athletic Training (Parrott 100)
	Reed - Biology Lab
	Reed - Engineering Lab (Reed 101)
	Reed - Geology Lab
	Reed - Science Lab (Reed 118)
	Shine.fm Lab
	Weber Center - CSIS (Lower Level)
	Weber Center - Business Department (Weber 103)
	Weber Center - English Division (Weber 307)
	Wisner Hall - Nursing Lab (Wisner 146b)
	Other

If you chose 'Smart Classrooms' OR 'Other', please specify the location below:

Smart Classrooms:
Other:

Does this software need to be available for students to purchase? YesNo