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Space Request/Reassignment Form

UVU Facilities Planning
MailStop 155

All proposed space requests or reassignment of university facilities must be submitted for approval using this form.

Space Request/Reassignment Notification
Building Name or Location
Room Number(s)
Project Representative
Department/Title
Name

Required Signatures
Name of Department Head or Director
Name of Dean
Name of Vice President
Manager, Academic Scheduling Office
Signature SIGN HERE Signature SIGN HERE Signature SIGN HERE Signature SIGN HERE

How will this Request impact other departments/divisions, and if so, have you discussed this Request with them?
What semester would this new utilization and/or reassignment become effective?

Justification/Explanation

Additional Comments
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