SPACE PLANNING AND SPACE UTILIZATION COMMITTEE REQUEST FOR SPACE REALLOCATION

Requestor Date Campus Unit

LIST THE SPACE NEEDED (complete as appropriate for requested space) Use of Space: Size of the area: Seating Capacity: Lab station capacity: Other:

Features Required: (technology and/or equipment, ventilation, power, compressed air other special needs)

LOCATION FOR THE SPACE DESIRED Where on the Flagstaff campus: Area of campus: Building: Rationale for location requested: (Contiguous space relationships and functions)

First day of use Day/Month/Year Reallocation is intended to be: Permanent Temporary If temporary- duration of use : Months Years Vacating Existing Space: No Yes If yes, specify: Projected growth of program Students Faculty Staff Research personnel served: Students Faculty Staff

Are Renovations Needed No Yes Are Dollars Available No Yes Routing------

1. 2. Budget Authority/Dean Date Responsible Vice President Date

3. Received by SPSU Chair Initials Date Recommendation

4. Recommendation sent to administration SPSU Chair Date

Approved Denied For Cabinet

D:\Docs\2017-12-14\0bf10549ff4ea58ebd5e25912b66af87.doc SPACE PLANNING AND SPACE UTILIZATION COMMITTEE REQUEST FOR SPACE REALLOCATION

A justification based on the university strategic priorities, personal needs, projected growth of program and other relevant factors must accompany this form.

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