Request to Change a Current Employee's Assigned Work Space

Request to Change a Current Employee's Assigned Work Space

Must be completed by Division Chair or Unit Head
Your name*
Today's Date*

MonthDayYear
Date
Check the box below, if this CON employee no longer needs an assigned, physical space

This employee no longer needs an assigned, physical office space
If the employee will be issued College of Nursing equipment, I understand that the employee and division chair or unit head will complete a Certification Statement for Off-Campus Location/Use of Equipment Form.*

I AgreeEmployee will not be issued College of Nursing equipment
Download: Certification Statement for Off-Campus Location/Use of Equipment Form
CON employee that is moving*

First NameLast Name
Site location*
Expected office move date (allow ten business for this process)*

MonthDayYear
Date
Old office space*
Shared office space. Please describe where in the room they are currently sitting, e.g., by the door, window, west wall.
New office space*
Shared office space. Please describe where in the room they will be sitting, e.g., by the door, window, west wall.
Employee to inherit the telephone number of the new office space, unless you check below -- approve of paying the telephone line transfer fee.
Check if phone line is to be moved

There is a $82.50 charge for the first phone line move. $27.50 for each additional move on the same date.
Current Phone Number*

Area CodePhone Number
Account to be used for transferring this CON employee's telephone line*
LHTI will move computer equipment only. The employee will be responsible for moving office supplies and personal belongings, including personal printers.
Should be Empty: