Space Request Form

Instructions:

Complete, print and send an unofficial copy of your space request by clicking the Submit this form button. After obtaining an authorized signature from the Dean / V.P., submit the completed form to ADM 467.

Contact Information Date of Request:

Unit Name:

Contact Name:

Title / Position:

Phone Number:

E-mail:

Program Information Is the Program new or existing?

Description of program or persons that will use the space:

Total number of faculty / staff that will be assigned to the space:
Full-time Faculty:
Part-time Faculty:
Full-time Staff:
Part-time Staff:

Space Requirements Number of Space(s) requested:
Faculty Office
Department Office
Lab
Other

If 'Other' please describe:

Reason(s) why space is needed:
(you may provide supporting material when you submit the official signed request)

Has the new program / expansion been approved?

Does the space need to be on the main campus?

Length of time the space will be needed:
Start Date: End Date:

Which other programs may be affected by the space change and how?

Describe the impact if no new space was assigned:

Any suggestions to fulfilling the request?
If you would like to illustrate your request, contact the Office of Space Management.

Funding sources and cost estimates:

Other factors to consider:

Approval and Signatures Dean / V.P.:

Finish and Compile

Clicking the submit button below will compile your input into a printable form and will automatically forward an unofficial copy of that form to the Office of Space Management. You may also choose to email the form to yourself or your dean and print it later. However, the form is not official until the hard copy has been filled out in its entirety, signed by the dean and submitted to the Office of Space Management.

Email yourself a copy of this form (Make sure your email address is correct above)