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Please provide the following in appropriate detail.

Department:

Person within your department to contact for clarification: 

Proposed location:

Is this request reflected in your five-year plan?   

In what academic year do you propose to open (upgrade) this classroom?

Which computer platform (Wintel or Macintosh or Both) do you propose?

What software will you require on the teaching station?

Do you anticipate the need to upgrade the software within three years?

If so, what is the anticipated need?

What special hardware needs do you have above the current minimum configuration?

What peripherals (scanners, remote mice, etc.) will you require for this classroom? 

Please estimate the number of students, classes, or departments that will be served by this lab?

Please detail your rationale for the construction or upgrade of this classroom including a statement of your primary purpose.

Please detail how this installation will help meet the mission of your department and the overall mission of the university.

Do you have in place a means to evaluate the effectiveness of this installation with regard its purpose and the overall mission of the department and university?  If so, please detail the evaluation plan.

Signature of department head: ___________________________________

Signature of dean: _________________________________________

Signature of Provost: ___________________________________