Pre-College Programs
Faculty Needs Form
Note: If you are teaching multiple classes, please complete a separate form for each class.
Full Name
*
First Name
Last Name
Program
*
Mini Medical School
Hajim Engineering Program
The Art of a Short Film
Business Program
English Language Program
Rochester Scholars, Session A (2 Weeks)
Rochester Scholars, Session B (1 Week)
Course Name:
*
*
Any
supply
requests
or
field trips
must be submitted no later than
one month prior
to the start date of your course. Any requests recieved after this cannot be guaranteed.
SUPPLIES NEEDED FOR COURSE
Please Note:
Basic office supplies such as pens, pencils, notebooks, binders, folders, copies/handouts, and select textbooks will be provided
upon advanced request.
All supplies become the property of the Office of Pre-College Programs.
Supplies Needed
Pen for each student
Pencil for each student
Notebook for each student
Folder for each student
Binder for each student
Other Supplies Needed
Please specify amount needed for each supply.
Do you need a textbook?
Yes
No
Purchasing Supplies & Reimbursements:
You are welcome to purchase your own supplies for your course.
Supplies must be approved by the Pre-College Programs before purchasing. Please submit these requests to
PreCollege@Rochester.edu
.
Supplies purchased should not exceed $250 per class, unless prior approval from the Pre-College Program.
Original saled reciepts must be submitted no later than the final day of class for reimbursement.
For more information, please see the reimbursement section listed at the end of this form.
TEXTBOOK(S)
Textbook #1
Option 1
Option 2
Option 3
Title
*
Author
*
ISBN
*
Cost
*
Vendor
*
Website to order textbook.
Quantity
*
Please state any other pertinent information needed to successfully place the order.
Textbook #2
Option 1
Option 2
Option 3
Title
*
Author
*
ISBN
*
Cost
*
Vendor
*
Website to order textbook.
Quantity
*
Please state any other pertinent information needed to successfully place the order.
Copies
: Pre-College Programs will make copies for your class as needed. Please email the materials to precollege@rochester.edu at your earliest convenience but no later than 48 hours in advance.
Room Needs:
Please provide the room needs you have for the class you will be teaching.
Class Name:
Session:
Standard Classroom: Please mark and describe below your needs/desires within a standard classroom.
Dates/times you need a classroom:
Please mark one and underline which classroom type needed:
Need
Desire
Choice 1
Desks/Tables/Moveable Chairs :
Need
Desire
Specify whether you need desks, tables, or moveable chairs:
PC/MAC Computer Lab:
Need
Desire
If needed, which dates/times are the computer lab needed?
Projector:
Need
Desire
If needed, which dates/times are the projector needed?
DVD Player/TV/VCR:
Need
Desire
If needed, which dates/times are the DVD/TV/VCR needed?
Stage Area:
Need
Desire
If needed, which dates/times are the stage needed?
Chemistry/Biology Lab:
Need
Desire
If needed, which dates/times are the lab needed?
Please list all your computer software needs:
Please list what supplies you will need to use within the labs you are requesting:
Note: If you need access to a lab (ex. Chemistry/Biology lab), you may need to go through an online OSHA training previous to the use of the lab.
Additional Information: Please list any other specifics you need/desire:
Field Trips:
Please state if you would like Pre-College Programs to arrange the field trip, including but not limited to, transportation, admission tickets, lunches, etc.
Destination:
*
Address:
*
Date of the trip:
Pick-up time & location at UR:
Pick-up time & location at destination:
Drop-off location at UR:
Cost:
Admission fees:
Additional logistics:
Permission slip needed? If so, please provide and indicate date it will be due:
Guest Speaker:
Name:
Affiliation:
Will they require parking, lunch, or compensation? If so, please provide further specifics:
If your guest speaker will be compensated and is not UR-affiliated, please have them complete a
W-9
form and submit to via email, fax, mail, or in person.
Reimbursements:
If we complete the reimbursement paperwork on your behalf, please keep in mind that you will need to sign the completed paperwork before it can be sent to Accounts Payable for processing.
University of Rochester Faculty & Staff
: Please complete and sign an
F3
and forward to the Office of Pre-College Programs. If you need assistance with the process, please let us know and we are happy to assist you. To check the status of the reimbursement, please log into HRMS.
*Please note: If your reimbursement is under $200, you have the option to take your completed
F3
form to the Bursar"s Office on campus instead of waiting for your check to be sent. If you are interested in taking your paperwork to the Bursar"s office, please let us know this when you paperwork is submitted to our office.
University of Rochester Postdoctoral & Graduate Students
: Please complete an
F3
form and forward to the Office of Pre-College Programs. If you need assistance, please let us know and we are happy to assist you.
*Please note: The reimbursement you receive will be sent by check to the home address you have listed in HRMS or direct deposit (base on how you receive you regular paycheck).
Non-UR Affiliated Instructors & Alumni
: Please submit original receipts to the Office of Pre-College Programs. The receipts need to display an itemized list of what you are requesting to be reimbursed for and we will submit the paperwork to Accounts Payable on your behalf. Please note that processing time could take up to one month.
If you have any questions, please contact the Office of Pre-College Programs at 585-275-3221.
Submit
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