Space Request Form

Space Request Form

Existing space must be utilized as effectively as possible in order to support desired growth. Any activities that require additional space should be addressed first within a department's current allocation, then within an organizational unit, school or college. This form is to be used for requesting additional space outside of current allocations. Requests from academic units will be reviewed by the Provost’s Office and from units from all other Divisions by Facilities Planning, Department of Planning & Construction.
INFORMATION:
Requestor (Primary Contact):
Dept/Unit/Center/School:
Phone:
Email:
Date:

SUMMARY OF REQUEST:

Request for Additional Space to support new or expanded activity
Request to relocate to a new location
Lease request
TYPE AND NUMBER OF SPACES REQUESTED :
BUILDING AND LOCATION (Identify any adjacency requirements to other units/programs):
WILL THE IDENTIFIED AREA REQUIRE REHAB? If yes explain.
WHAT SPACE WILL BE VACATED IF THE ALLOCATION IS MADE?
ARE NEW FURNISHINGS REQUIRED
LIST ANY SPECIAL EQUIPMENT REQUIRED:
PEOPLE TO OCCUPY SPACE (Add lines as needed):
Name / Job Classification / Appt. Level (% FTE) / New Hire? / Existing Staff?
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SPACE NEEDS ASSESMENT:
Provide an updated inventory of your existing space. Include room types and square footage
Have you tried to meet your space need within existing inventory? Please explain the conclusions.
In what way is your current space inadequate for the identified need?
Have temporary arrangements been made to use any of your existing space for the requested purpose? If so, please explain:
How long will the space be used for the requested purpose?
What is the anticipated time-line for moving into the requested space?
How does your request fit with the role and mission of the unit, school, college, and university strengths?
What are the benefits (financial, programmatic, etc.) that will occur as a result of having your request granted?
How will you pay for moving, and/or renovation costs of the requested space? (If using grant/award money, please confirm that this is an approved use of the money and the maximum amount available).
If this request is denied, what will be the consequences?
Please attach floor plans and/or sketches and supporting documents for this request.
This request has been reviewed and approved for submission by the Dean/Director/Unit Budget Administrator / ______
Signature
______
Print Name/Title:
Upon completion of this form, all materials should be forwarded as follows:
A thorough analysis of this request and supplemental material will be reviewed with the requestor. The final recommendations regarding this space request will be discussed with and determined by the Senior Vice President.

OFFICIAL USE

SPACE REQUEST #
Evaluation Date:

Yes No / Does this request fulfill Department, School/University missions and goals?

New Existing / Is this renovation of existing space or new construction/lease?

Yes No / Are funds available for this project? Explain in recommendation.
Recommendation:

APPROVAL PROCESS:

This request has been reviewed by the Special Assistant to the Provost or the Director of Facilities Planning / ______
Signature
______
Title
This request has been reviewed and approved by the Provost / ______
Signature
______
Mary Ann Rankin/Senior Vice President and Provost