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Annual Activity Report

Faculty Room Change

Use this form as you would the paper copy. Completed forms are sent to Robert Drobish.

Fields marked with * are required.

*First Name
*Last Name:
*Department:
*Phone:
*SCSU Email: Your SCSU E-Mail address in full, e.g. yourname@southernct.edu. No other email addresses will work.
Semester:	Fall Winter Spring Summer
*Year: (Last two digits)
*Course: (e.g. COM 100-02)
*Section:
*Day/Time: (e.g. TR 11am)
*Current Room Assignment:
*Requested Location:
*Current Enrollment:
*Anticipated Final Enrollment:
*Reason for Request:
Special Needs:
Send a Copy to Your Email Address?:

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