Request for New Space Allocation

Requesting Department
Date of Request Date of Request / MM / DD YYYY
Contact Name
Contact Phone Contact Phone - ### - ### ####
Contact Email
Building Information

Please provide building name and room number(s) of space to be reallocated.
Building Name
Room Number(s)
Please describe reason for new space.
Space will be used for:

Space will be used for: Classroom Office Exam Room Storage Research Lab Other Other
Have you identified a suitable location that may be available for this space?

Have you identified a suitable location that may be available for this space? Yes No
Is the space currently occupied by another department?

Is the space currently occupied by another department? Yes No Not applicable
Have you contact the current holder of the space?

Have you contact the current holder of the space? Yes No
Do they support the concept?

Do they support the concept? Yes No Unknown
When is space needed?
Will you need new or additional furnishing?

Will you need new or additional furnishing? Yes No
What are the implications if this request is not approved?
Funding Information
What is the source of funds for the renovation?

What is the source of funds for the renovation? College Department Division/VP Grant Funds not Indentified Other Other
What is the budget for the project?
Required Authorization
Name of Department Chair or Director
Email
Date Date / MM / DD YYYY