The University of Vermont
Renovation and Construction Project
Request Form

Describe Project, Program and Identify Funding
Building Name:		Project Title:
Person to Contact:	Department:	Phone Number:	E-Mail Address:
Need for Project:
Description of Program and Scope Definition:
Description of Proposed Funding:
Department Head:		Phone Number:	E-Mail Address:
Signature of Department Head		Date	Date Needed

Support of Strategic Plan: Describe how the project supports the following areas of the strategic plan: 1. Recruit and support students on campus. 2. Increase the quality of the educational experience in and out of the classroom. 3. Support faculty scholarship and research. 4. Provide service to benefit the university, the state, the nation and the world. 5. Support the continued viability of UVM.

Disposition of Existing Facilities:

Dean or Vice President
Priority Level: High Medium Low
Chartstring Information Op Unit Department Fund Source Function PC Business Unit Project Activity Program Purpose Property 0
Request Estimate (only if providing funding)
Signature of Dean		Date

For Director of Capital Planning & Management Use Only
Project Number:
Date Received:
Date Completed:
Date Revised:
Capital Planning and Management Signature Date	Campus Planning Services Signature Date

Provost/Vice President
Signature of Provost/Vice President	Date