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SPACE ALLOCATION/CHANGE FORM
REQUEST FORM
INSTRUCTIONS:
Use this form to request department or program space assignments, reassignment, alterations, or changes for
review.
Recommendation and approval. Completed forms, along with attached justification, must be approved by your
Vice President prior to submission to Facilities Maintenance & Construction.
Date: _____________________________________
Requesting Unit/Department: _________________________________________________________________
Requestor’s Name: __________________________________________________________________________
Campus Phone: _______________________________Campus E-Mail: _________________________________
Request for New Space
Request for Change in Space Type
Alteration of Current Space
Reassignment of Current Space (Moves)
In your justification for the request for space, please address the following:
PROGRAM INFORMATION
a. Describe the program that will use the space and why the space is needed.
b. Is this a new or existing program?
c. Has the new program or expansion been approved?
d. How does the program relate to the University’s strategic, academic and/or master plans?
SPACE REQUIREMENTS
a. What type of space are you requesting?
b. If requesting instructional space, what size do you have the greatest need for?
c. When do you need the space?
d. How many faculty/staff/students will be assigned? Full-time, part-time, students, etc.
e. Are there special requirements of the new space? (e.g., location, adjacencies, etc.)
f. Describe briefly why your existing space is inadequate
g. What other programs might be affected by this space change?
FUNDING SOURCE
University Funded: ________________________________
Non-State: _______________________________________
Capital Outlay: ____________________________________
Other Funding: ____________________________________
Cost Recovery: __________________________
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SPACE ALLOCATION/CHANGE
REQUEST FORM
AUTHORIZATIONS
Requesting Department Head
Name: ________________________________________________________________________
Title: __________________________________________________________________________
_____________________________________ ___________________________
(Signature) (Date)
Vice President
Name: ________________________________________________________________________
Title: __________________________________________________________________________
_______________________________________ ____________________________
(Signature) (Date)
Upon completion, please forward the approved form with attached justification to Space and Facilities
Planning:
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3 | P a g e
SPACE ALLOCATION/CHANGE
REQUEST FORM
Facilities Planning Use Only
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Date of Review: __________________________________
Recommendations Made:
Action Taken:
Approved by Executive Director of Facilities, Maintenance, and Construction
Name: ______________________________________________________________
Title: _______________________________________________________________
__________________________________ __________________________
(Signature) (Date)
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