Request to Change Function of Space

If renovations are required, a Request for Renovation form must also be submitted.

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 changed.
Building Name
Room Number
If more than one room is involved, please list information below.
Current Use of Space
Proposed Use of Space
Reason for Change
Required Authorization
Name of Department Chair or Director
Email
Date Date / MM / DD YYYY