All new requests must be approved and submitted by the appropriate Dean or Department Chair. Please identify the Dean / Department Chair by:

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*Name:

*Title:

*Office address:

*Email:

*Telephone:

*This request is being submitted for what Department or Unit?

*What is the precise schedule being requested? Indicate specific start/stop hours for specific days and for what calendar period? (Please consider only the hours for your occupation of the space. Operations Division will evaluate the need to start the units early for preconditioning.)

*Building and room numbers for which the exception is requested:

*Summarize how this request is critical to your specific function:

*Describe the results if this HVAC exception is not granted:

*The request process includes on-site analysis by Operations Division personnel. List name and contact information of the person(s) who will be coordinating site access and scheduling:

*Is the department prepared to fund this request if third-party funding is not approved?

*Submitted By:

*Date of submission:

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