Room Change Request Form

**REQUESTS MUST BE MADE ONE WEEK IN ADVANCE**
**ONE FORM PER REQUEST**

Date:    
Instructor's Name:
last, first 		Department:
Phone Ext:
xxxx		 Alternate Phone#:
xxx-xxx-xxxx
Semester: E-mail:
(must be KCC email)
e.g: first.last@kingsborough.edu
Course & Section: Class period/ Time:
Assigned Room(s): Class Size:
** Please make your request NO LATER than FIVE business days prior to date needed **
**ONE FORM PER REQUEST**
Start Date For Room Change:


Reason for requested room
change:
Special requirements:
(Subject to availability)