Purchase Requests

If you need something ordered for you or your program, please complete the Purchase Request form below. The form will be routed to your supervisor for approval and then, to the Whitewater Office for a PO to be created and the purchase processed.

Please note that a separate purchase request must be submitted for each vendor or entity if you are requesting items from more than one vendor or entity. Requests received with multiple vendors listed on one request will be rejected and need to be re-submitted as separate requests.

List of Program Account Codes

Watch the video on how to use the form:

Purchase Request form

Use this form to indicate an item(s) that you're requesting be purchased.

Name*
First Last
Email*
Program*
- Administration
- Head Start
- Professional Resource Center / AT Library
- Other Programs and Services (Digital Learning, Curriculum & Coaching, Language & Culture, etc.)
- Specialized Services & Staffing
Please indicate the area or program the items are for.
Date*
MM slash DD slash YYYY
Item description*
Please include item number if applicable.
Reason for Purchase*
Please indicate why this purchase is needed for your work.
Quantity needed*
Price per Item*
Shipping Cost
Vendor*
Please list the vendor the item(s) should be purchased from. If you are requesting items from multiple vendors, you must submit a separate purchase request for each vendor.
Link to Materials/Item*
Subscriptions/Memberships
For subscriptions or memberships, please let us know if you already have an account and what the account is listed under.
Vendor Address
Vendor Phone Number
Date Needed By
Where would you like the items to be shipped?*
Let us know if you'd like the items sent to the Whitewater office or somewhere else.
Account/Program Number*
Specialized Services Items
- General Use
- Specific district/student
Please indicate if the item(s) to be purchased are for general use or for a specific school district and/or student.
School District
Enter the school district name if this is an item being purchased for a specific district.
Student
Enter the student's name if this is an item being purchased for a specific student.
Audiology Items only
- Audiology resale
- Audiology stock
Please indicate whether the item is for audiology resale and audiology stock.
Supervisor / Senior Director

Purchase Request form

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