Pooled Classroom Change Request Form Pooled Classroom Change Request Form Pooled Classroom Change Request Form Semester * FL SP SU Course Number, Section and Sub Section (Discussion, Lab, etc. if relevant) Instructor’s Name Requestor’s Name if different from Instructor Classroom Assignment Reason for Pooled Classroom Change Request Classroom does not accommodate instructor’s health needs. Please visit https://hr.wustl.edu/items/ada-accommodation-process/ to submit the HR accommodation approval form. Different seating style required Non-standard specialized features required in classroom Broken or missing standard equipment/set up If you selected different seating style, please select required style* Fixed seating Seminar Tablet armchairs Senate style (tiered tables) Auditorium If you selected broken or missing standard equipment/set up, please select item missing or non-functioning* Computer (PC) Laptop HDMI Projector Drop down screen Recorder / Camera Podium If you selected non-standard specialized features required in classroom, please select feature Periodic table Demo / experiment set up compatibility Specialized software Large-scale projection needs (e.g., for film screenings, projection booth (requires permission)) If you are human, leave this field blank. Submit