Fri, Feb 10, 2012	Space Committee Request Notice: All Requests must be received by the fourth Tuesday of the month to be considered for the next month's Space Committee Meeting. Requester Name (First & Last Name) Requester's Email Resolve Email Director's Name (First & Last Name) Dean-Vice Chancellor (First & Last Name) Department Phone Mail Slot Extension Reason(s) for the need of space: Healthcare Inpatient Healthcare Outpatient Education Research Administrative Residence The need is: Temporary Assignment Assignment Please give a description and justification for the need of space: (example: Number of offices, laboratories, classrooms, conference room, etc.) Do not exceed 1,000 characters (not words!) or the submission of this form will fail! Count the # of letters in your description by using this handy Character and Word Counter Errors Found! Please correct errors indicated in RED and resubmit.

University of Arkansas for Medical Sciences
Design & Construction, Slot 605
Physical Plant Building, First Floor, Room # M1/400
4301 W. Markham St., Little Rock, AR 72205

Front Desk, Call 501-686-5890
Fax 501-686-6173
Business Hours 7:30 am - 4:00 pm, Monday - Friday

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