Space Request You must have JavaScript enabled to use this form. Date of Request: * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20192020202120222023 Requesting Department: * Appointing Authority or Authorized Agent: * BGS/Vision Customer #: * Billing Address: * Coordinator / Contact Person: * Phone: * Email: * Back up Coordinator: Back Up Phone: Back Up Email: Current Location: * (Town, Building, Floor, Room) Desired Location: * Current No. of Positions: * Anticipated No. of Positions: * Funding Available for New Space: * Yes No Funding Available for Move/Construction: * Yes No Funding Source: * (Agency Funded, Capital Construction, Major Maintenance) Department ID: Desired Move Date: * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year202120222023 Type of Space Required: * (office, warehouse, etc.) Special Requirements: * (waiting rooms, conference rooms, etc.) Construction Required: * Yes No Justification & Additional Description * Authorized Maintenance Connection Users in Your Building: *