REQUESTOR INFORMATION
Contact Name
Contact Title
Project Request Form
Planning and Construction Services
PCS-PRF-2017.1
PROJECT INFORMATION
Building or Site
Room or Area
Division
Phone
Email
VP Name
PRF Completed By
Please select from list
Please select form list
Is this space currently assigned to the requesting department?
Yes
No
Date of Request
Desired Start Date
Desired Compl. Date
PCS USE ONLY
Requesting department is fully funding project.
Requesti
ng department is partially funding project.
Project is currently unfunded
Amount available if fully or partially funded
Is project being funded through auxiliary or housing reserves?
Chart String(If applicable)
Date
Received:
Validated By:
PCS Director:
PM Assigned:
Comments:
Description of Project Scope Please be specific, and attach supporting documents or sketches as needed
Justification for Project
Consequences for not completing this project within requested time frame
APPROVALS
Director/Chair
AVP/Dean
Division VP
VP Bus & Fin
Date:
Date:
Date:
Date:
Approved by: AVP CP&F
Questions? Planning and Co Services
Phone: x96371
Attach additional sheets as needed.
Please check one and include amounts
Please select from the list
