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EOU Space Request Form
Requestor Information
Name:
Position:
Contact Person:
Department:
E-mail:
Phone:
Space Information
Briefly describe your space need (i.e., program expansion, recruitment, etc.):
Space Type(s)(i.e., office, lab):
This request is for (select all that apply):
Change of space
function New Space
Relinquishment
Temporary Space
Time Frame: From: To:
List any special requirements needed (i.e., location, access, equipment, adjacencies):
Are you requesting a specifically identified space?
No, I would like to consult with the Campus Planning Office.
Yes. Which space(s)?
Will any space be vacated as a result of this request?
No
Yes. Which space(s)?
Is funding available for any necessary improvements?
No
Yes. Funding Source:
Dean or Director Authorization
I approve this request for consideration by the Space Use Advisory Committee.
Name: Date:
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Date:
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signature
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