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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 section. Classroom change requests will be fulfilled pending availability.

If a classroom has not been assigned to your course section, 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. Requests will be fulfilled pending availability.

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


Step 6 - Please indicate your preferences for distance-enabled technology. Requests will be fulfilled pending availability.

microphone for presenter
microphone for classroom participants
                                                                                     
instructor touch screen monitor
camera facing presenter
camera facing classroom participants
                                                                                     
secondary/confidence monitor

Step 7 - Please provide information about your location preferences:

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

Step 8 - Please enter any additional comments below: