Additional Instructional Materials Request Form

The purpose of this form is to request additional funds to purchase instructional materials/textbooks that you are not able to afford with your annual school-based instructional materials allocation. Please check the balance of your school instructional materials 21505 account prior to submitting this form. If you have the funds to make the purchase submitting this form is not necessary.

This form is to request funding for core instructional resources to be used in the classroom that are NOT computer-based.

For ease, you are able to include all the materials and dollars you need in one request. If you are requesting funds for multiple content areas, please upload all associated quotes.

* A vendor quote must be obtained before completing this request.

General Information

Please answer the following questions regarding the school and person making the request.
School Level:

Select the school level that this request is for. If other is selected, you will be asked to provide the school/location name.
Select the Elementary School:
Select the Middle School:
Select the High School:
Select the Combo School
Requested By (Name, Role):

Enter the name and role of the person making this request. This will be the person who is contacted with any questions or clarification.
Email Address:
Instructional Purpose & Materials

Please answer the following questions regarding the instructional purpose of the materials for which you are requesting.
Grade Level(s):
Course(s) for which the curriculum materials will be used. Must include course number(s):

If more than one course will be using the materials, list all course numbers here.
Are materials for an AP course included in the request?
Reason Needed:

Reason Needed: Enrollment Growth Replacement Undated Version/Edition of Adopted Materials New Material Other/Combination of the above Other/Combination of the above
Provide a detailed rationale for the need of these resources.
List the resources needed below by course. Include the title, ISBN, copyright/edition, and author/publisher.
Will the resource(s) will be used as Core Instructional Materials, Supplemental, Intervention or Extension?
Total money needed

Please complete the following fields with the total amount of money needed to complete your order(s). Be sure to check your school based IM account (Project 21505) to see if you have funds left over that can be used towards this purchase.
Total Amount of Money Needed: $ Dollars . Cents
Subtract any money in your school's instructional materials account from the amount listed on the quote if applicable. This should include all applicable fees including shipping and handling.
Upload Vendor Quote(s):

Attach Files

Multiple files may be uploaded if needed.
PLEASE NOTE: If this request is for consumable materials, a new form will need to be completed every year and funding is not guaranteed.
Questions?

If you have questions or need assistance email us at: instructionalmaterials@pasco.k12.fl.us

Additional Instructional Materials Request Form

Additional Instructional Materials Request Form

General Information

Instructional Purpose & Materials

Total money needed

PLEASE NOTE: If this request is for consumable materials, a new form will need to be completed every year and funding is not guaranteed.

Questions?