Simulator Request Form

Name of Requester*

Requester Email Address*

Today's Date*

What simulator would you like CSEAC to purchase?*

If you have a specific simulator in mind, please list the make and model.
If there are several competing products on the market, we typically ask faculty to evaluate models.

Please describe the educational goals:*

Who will be trained on this simulator/equipment?*

How many trainees (and departments) will use this simulator/equipment?*

Any additional information that would be helpful in this review?