Request a Change to Existing Academic Facilities

(for use by department chairs and deans only)
All fields are required.

This is a request for (select one)
Additional office or classroom space
Reassignment of office space
Change of use for room(s) or area(s)
Major repair or renovation of room(s) or area(s)

Building:

Room Number(s):

What is your request?
What academic programs will this affect?
What impact will this change have on the delivery ofthese academic program(s)?
What would be the consequences to the delivery of these academic program(s)if this request is not met?

What is your request?

What academic program(s) will this affect?

What impact will this change have on the delivery ofthese academic program(s)?

What would be the consequences to the delivery of these academic program(s)if this request is not met?

Your Name:

Your Academic Department:

Your Telephone Number:


Academic Affairs Richards Hall, Third floor, rooms 300-315 Ph: 706-568-2061 \| 706-568-2062 Fax: 706-569-3168	Text-only version Questions/Comments?	Columbus State University 4225 University Avenue Columbus, Georgia 31907 706-507-8800