SMCCD
201609.v2
SMCCCD Facility Project Request Form
Is this an emergency (imminent threat to persons, property or equipment? Please contact Facilities immediately
Step 1: Requestor fills out the form below, signs and submits to Dean/Administrator.
Request Date:
College:
Requestor Name & Title:
Building Name / Number:
Division or Work Area Name:
Specific Room Number(s) (If Applicable):
Please provide a description of all the work requested:
Requestor (Signature) :
Step 2: Has this need been articulated via Program Review, Student Learning Outcomes, or other institutional planning
documents? If so, please attach a copy of the relevant section of the document. Sign and forward to Facilities
Manager.
Dean / Administrator (Signature) :
Step 4: VPA provide Funding Code, sign and forward to the VC of Facilities Planning, Maintenance & Operations.
Funding Code (FOAPA):
Vice-President of Administration(Signature):
VC Facilities Planning, Maintenance & Operations (Signature) :
Step 3: Provide Cost Estimate, sign and forward to Vice-President of Administration.
Estimated Project Cost:
Facilities Manager (Signature) :
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