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Academic Change Request Form for Central Pool Classrooms

Use this form to request a change in the classroom already assigned to a course.

If a classroom has not been assigned to your course, please contact your department. Instructors teaching LPS courses should contact the College of Liberal and Professional Studies.

*** All fields in RED are required. Please provide complete information. ***


Step 1 - Please provide information about yourself:

Name:  
Telephone Number:  
Full Email Address:  
Affiliation:  

Step 2 - Please provide the subject and course/section numbers for the course that you want to relocate.

   
Course Information:

-


Step 3 - Please provide information about why this change is requested:

Reason for Change:

Step 4 - Please provide information about the preferred classroom for this course:

Preferred Classroom Layout:

Step 5 - Please indicate your audio-visual equipment needs:

computer w/ Windows™
computer w/ Macintosh OS
laptop computer input
wireless projection/collaboration
 
DVD player
DVD player (region-free)
Blu-ray™ player
 
wireless Internet access
 
installed assistive listening
adjustable height instructor's table
electrical outlets at student seats
 
classroom recording
wireless microphone (lavaliere)
wireless microphone (handheld)
podium microphone
additional microphone inputs
 
CD player
phonograph
 
 
document camera
overhead projector
 
projection screen
multiple projection screens
wide screen projection/display
 
projection annotation
Other audio-visual equipment:


Step 6 - Please provide information about your location preferences:

First Classroom Choice:
Second Classroom Choice:
Third Classroom Choice:

Step 7 - Please enter any additional comments below:

 


Other Request Forms:
    Academic Event Scheduling
    Special Event Scheduling     Classroom Lecture Recording
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Information Systems and Computing
University of Pennsylvania
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Information Systems and Computing, University of Pennsylvania