Request for Technology
in a Departmental Space
or General Use Space


Division of Facilities

Please complete the following form describing the technology you need for the departmental or general use space. The form will be sent to Dale Rivett at drivett@ksu.edu

There is no charge for completing the request form.

After receiving the request, technology and facilities personnel will be in contact with you to gain a better understanding of your request.
Please understand that all technology requests are reviewed by the Technology Classroom Planning committee.

Please do not use abbreviations for Buildings or Departments!

* required fields


Name of Requester*
Department Name*
Building (Mailing Address on Letterhead) *
Main Office Room # *

Building (Where Work is to be Done) *
Room # (Where Work is to be Done) *


Primary contact person *
Room # (Office #) *
Phone Number *
Email *

Second contact person*
Phone Number *
Email *
Approving Department Head *
Department Head Email Address *

Identify the current owner of the space:
Departmentally managed space
University managed space
Identify the funding sources for this renovation:
Departmental funds (Provide account number in the comments)
Do not know
Please provide a description of the request. Provide as much detail as possible including objectives for the space, use/capacity, and any other pertinent information so that we can route this request appropriately.*