AHA Purchase Approval Form

Please complete a separate form for each vendor (e.g. if you want to make a purchase from Target
and Office Depot, complete two different forms)

* Indicates required question

1. Email *

2. Name *

3. Date *

Example: January 7, 2019

4. Please list the items you would like to purchase AND the links to the items. *

5. From where are you purchasing these items? *

6. What will be the total cost of these purchases? *
If you are not sure of the total cost yet (e.g. you plan to purchase these items from Target
but aren't sure how much they are), write an approximate cost and submit the receipt after
you purchase the items with your reimbursement form as usual.

7. In the absence of special education needs, would this cost exist? *

Mark only one oval.

Yes

No

8. Is this cost also generated by students without disabilities? *

Mark only one oval.

Yes

No

9. If it is a child specific service, program, supply or equipment, is the need documented in *

the student's IEP?

Mark only one oval.

Yes

No

N/A
10. If this is child-specific, please include the student's MARSS number below *
You will also need to attach documentation from the IEP (e.g. accommodations page).

11. Will this team, service, or project expand and enhance the direct instruction of students *
with disabilities?

Mark only one oval.

Yes

No

12. If this is a training, will this training expand and enhance the IEP process? *

Mark only one oval.

Yes

No

N/A

13. If this is a professional development opportunity or training, will it expand and enhance *
delivery of IEP specific disabilities services?

Mark only one oval.

Yes

No

N/A
14. Director/Coordinator Signature Date _______________________________
_________
For office use only.

This content is neither created nor endorsed by Google.

Forms