Fillable Change-of-classroom-request Change of Classroom Request

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Change-of-classroom-request Change of Classroom Request

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UW Space Assignment and Management
Change of Classroom
Change of Classroom Change of Classroom
Change of Classroom Classification Form
Classification FormClassification Form
Classification Form
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Introduction:
Introduction:Introduction:
Introduction:
UW Regulation 2-181 defines space assignment and management at the
University of Wyoming, and outlines how the process is to be carried out. Section two states that,
“It is the responsibility of each administrator with delegated responsibility for space management to
ensure that changes in assignment, classification and function, are reported to the FPO (Facilities
Planning Office).” Section four states “It is the goal of the University to maintain and preserve its
high quality instructional spaces. Requests to convert any instructional space to another use requires
a space analysis performed by the FPO to determine if there is a better alternative to the conversion
of a classroom to meet the needs of the unit making the request, and the approval of the Cabinet.”
In addition, “The FPO is available to provide an evaluation of space options and should be utilized
for resolution of space requests.” Additional references are made regarding participants and their
role in the space allocation process; this form is intended to assist in meeting those responsibilities.
Please complete the form and submit to the Facilities Planning Office.
I. Requested By:
I. Requested By:I. Requested By:
I. Requested By:
__________________________ __________________________
Department College/Division
II. Situation:
II. Situation:II. Situation:
II. Situation:
1. Change in the use of existing space
a. Building: _______________________ Room No. _________________________
b. Current Use: _______________________ Proposed Use:___________________
2. Classroom: Number of student seats: _______________
a. Seating type: Fixed____, Moveable____
b. Seating layout: Auditorium____, Tables/chairs____, Tablet armchairs____
3. Teaching Lab: Complete Addendum A
IV. Proposed Usage:
IV. Proposed Usage: IV. Proposed Usage:
IV. Proposed Usage: Please explain the proposed usage of the room.
1. Office Information: Person(s) and Title_______________________________________________
2. Office Service (copier, files, mail boxes):______________________________________________
3. Conference Room - seating capacity: ____________
4. Research Laboratory: Complete Addendum A.
5. Storage/Warehouse: ____________________________________________
6. Other ________________________________________________________ Sq. Ft.
IV. Timeline:
IV. Timeline:IV. Timeline:
IV. Timeline: The time the Classroom change in function would occur.
1. Temporarily: Beginning __________________ and ending ______________________.
2. Permanently: Beginning __________________________________.
Note: Please submit at least six months in advance of anticipated change.
UW Space Assignment and Management
Change of Classroom
Change of Classroom Change of Classroom
Change of Classroom Classification Form
Classification FormClassification Form
Classification Form
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V. Reasons for Request:
V. Reasons for Request:V. Reasons for Request:
V. Reasons for Request: Attach a detailed narrative that follows the below format:
1. Description: Please provide a succinct description of your change request, including what is being
requested and why. Indicate whether this is being driven by a new program, a research grant,
inadequate space to provide current program, and/or other reasons.
2. Proximity: Indicate other departments, organizations, programs, or functions which should be in
proximity to the requested space and why.
3. Location: Indicate the location of the classes to be displaced by change in classroom allocation.
4. Options explored: Provide assurance that all avenues to solve this space requirement within existing
space have been explored. For example, has the department/college considered maximizing under-
utilized space to solve this need? Has the department/college re-evaluated the space assigned to
lower priority initiatives? What possibilities for department shared classrooms have been explored?
5. Timing: Describe any programmatic issues affecting the timing of your change in classroom
allocation. Please allow six months for processing your request.
6. Parking/Transportation: Describe any special parking and transportation access needs.
7. Other: Any other information that will support or better define this classroom change request.
S
SS
Submitted/Endorsed by:
ubmitted/Endorsed by:ubmitted/Endorsed by:
ubmitted/Endorsed by:
______________________________________________
Signature of Dept/Unit Head (date)
______________________________________________
Signature of Dean/Director (date)
______________________________________________
Signature of Vice President (date)
______________________________________________
Signature of College Facilities (date)
Coordinator (if applicable)
Name of Department/Unit Contact Person:
_____________________________________
Building:_________________________
Phone:___________________________
Fax:_____________________________
e-mail:___________________________
Unsigned request will not be considered.
Please submit this request to the Department of Facilities Planning, Manager of Space Allocation, Merica
Hall, Room 208. Questions: call 766-2648.
Please note: After approval, it will be the responsibility of the requesting party to obtain cost
estimates from Physical plant for conducting any work or moving expenses. It will be the
responsibility of the requesting party to provide the funding for such expenses.
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UW Space Assignment and Management
Change of Classroom
Change of Classroom Change of Classroom
Change of Classroom Classification Form
Classification FormClassification Form
Classification Form
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Addendum A
Teaching Lab
Teaching Lab Teaching Lab
Teaching Lab
Number of student seats: __________ Number of computers: ___________
Lab type: Wet____, Dry____
Hazards: List all chemical and physical hazards, such as lasers, corrosives, drill press, etc. Attach a
separate list, if necessary.
Chemicals (list) ______________________________________________________
Processes and specific hazards (list) __________________________________________
Fumes Hoods: Number/Size __________________________________________
Waste (specify): Liquid____, Dry____, Biohazard____, Radioactive____
Amount (volume/week) ________________________________________________
_______________________________________________________________________
Are operations covered by an existing safety plan: Yes____, No____
Research Lab
Research Lab Research Lab
Research Lab
Number of workstations? __________
Lab type: Wet____, Dry____
Hazards: List all chemical and physical hazards, such as lasers, corrosives, drill press, etc. Attach a
separate list, if necessary.
Chemicals (list) ______________________________________________________
_______________________________________________________________________
Processes and specific hazards (list) _________________________________________
_______________________________________________________________________
Fumes Hoods: Number/Size __________________________________________
Waste (specify): Liquid____, Dry____, Biohazard____, Radioactive____
Amount (volume/week) ________________________________________________
_______________________________________________________________________
Are operations covered by an existing safety plan: Yes____, No____
_____________________________
Contract/Grant Effective Dates
_________________________
Total $ Amt. of Agreement
UW Space Assignment and Management
Change of Classroom
Change of Classroom Change of Classroom
Change of Classroom Classification Form
Classification FormClassification Form
Classification Form
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For Office Use Only:
For Office Use Only:For Office Use Only:
For Office Use Only:
Approval From:
____________________________________________________________________________
Academic Affairs (date)
____________________________________________________________________________
Central Scheduling (date)
____________________________________________________________________________
Classroom Technology Advisory Committee Representative (date)
____________________________________________________________________________
Space Allocation Committee Representative (date)
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Completed 14 June 2020

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