I. REQUESTOR INFORMATION Date:
Name: Email:
School/unit:
Phone Number: FAX Number:
II. THE REQUEST
a. Space Needs (by type):
b. Location (area of campus, building, rooms, etc):
c. Time Period (Length of time space is needed):
Start Date:
End Date:
d. Provide a brief description of the need for the requested space and how it relates to the school/unit's mission:
(existing problems, space shortages, etc)
e. Provide a brief description of how the space will be used:
(Programs to be located in the space, number of faculty, staff and students to be accommodated, etc)
f. Can space within the school/unit be reallocated to meet this need? Why/why not?
FILL
 
g. Are renovations or alterations to the space anticipated? If so, please describe.
III. FUNDING
Please describe the funding available for this project and cite the fund source:
a. renovations/alterations:
b. Incremental operating expenses:
IV. SIGNATURE OF DEAN/VICE PRESIDENT:
V.
REVIEWS (To be completed by Office ofCapital Budget and Planning)
Space Use Advisory Committee Date:
Vice President, A & F Date:
President Date:
VI. APPROVAL (To be completed by Office of Capital Budget and Planning)
Date:
Solution:
VII.
NOTES:
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