Space Request Form
Requestor's Name:
Dept. Making Request:
Phone #:
E-mail Address:

Type of Request:
Allocation of Space
 
Modification of Space
 
Change of Use

Duration:
Permanent
 
Temporary

Type of Space:
Office
 
Teaching
 
Meeting
 
Lab
 
Support
 
Other:
 
    

Reason:
Existing program support
 
Grant/Contract support
 
New Program
 
Faculty/staff change/addition
 
Services support
 
Compliance issue
 
Other:
 
    

Request:
 
(limit of 1700 characters)

 
Please include special needs/requirments such as Square Footage, AV, technical, structural, location, access, equipment, etc. You can
 
send an email to Work Control on the following screen if you run out of room.

Timetable:
Urgent (explain)
 
 
Needed by Date:
 
    

My VP/representative is aware of and concurs with proceeding with this request.
          
Note: The VP/representative will receive an email about your request.