Classroom Reassignment Request Form

Fields marked with an asterisk (*) are mandatory

Date of Request
Instructor Requesting Room Change*
Instructor's Email Address*
Instructor's College
Term
Course Number*
Course Section*
Course Title
Current Classroom Assignment
Reason for Request
Pedagogical
Disability
Other/Discretionary
If pedagogical, please explain the reason for room change
Please describe the classroom requirements/characteristics required to support this pedagogy
(e.g. type of seating, computer operating system, etc.)
If disability, please describe the nature of the accommodation requested
(The University reserves the right to request additional information regarding the medical necessity of the requested accommodation.)

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