Space Assignment / Reassignment Request - Office of Facilities Management

Requesting Department

Date

Requestor	Phone

Email*

A confirmation email will be sent to this address.

Request for New Space:

Check all that apply

When is space needed?

Description of Need

What are the implications if allocation of space is not granted?

Have you identified a suitable location that may be available for this space?

Building Name	Room Number

If Yes, provide building name and room number(s)

Is space currently occupied by another department?

Do they support the concept?

Have they submitted a Space Assignment/Reassignment Request?

Request to Change Function of Space:

*If renovations are required, a Space Modification/Renovation Request Form must also be submitted

Building Name:	Room Number(s):

Current use of Space:	Proposed Use of Space:

Justification for Change:

Building Name:	Room Number(s):

Current use of Space:

Explanation for No Longer or Still Needing Space:

Department Chair	Date

Dean or Director	Date