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Project Initiation Request Form

Office of Facilities Design and Construction

Sample form only.

(EXAMPLE ONLY) Project Initiation Request

Please print this page, complete Sections A and B, and forward to Facilities Design & Construction, 165 Wilber Hall

A. Requestor Information Date: _____________________________

Requestor’s Name: _______________________ Phone # ___________________________

Department: ____________________________ Campus Address: ____________________

Project Location: _______________________________________________________________

Current Space Use: ___________________________________________________________

Proposed Space Use: ___________________________________________________________

Project Description: (attach sketches if pertinent)


B. Department Dean or VP Concept Approval:

Concept Approval Signature: _______________________________ Date: ____________

Intended Funding Source:
 Department Operating Funds  Capital Funding (requires PC approval)  Other: _________________________


C. Space below for use by Facilities Management

Log # ___________________ Initial: ___________ Date: ____________

Forwarded to:  FO&E  FD&C Date: ____________

 Last Updated: 7/9/07