2015-2016 Laboratory and Classroom Modernization Request
Laboratory/Classroom: Click here to enter text.
Building/Room Number:
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Department: Click here to enter text.
Department Priority: Click
here to enter text.
Chair Signature:
Date: Click here to enter a date.
College/School: Click here to enter text.
College/School Priority:
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Dean Signature:
Date: Click here to enter a date.
I. Cost Estimate
Equipment
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Services and Supplies
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Remodeling
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Total
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II. Describe Equipment Requirements (Please list items to be purchased and estimated costs)
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III. Describe Services and Supplies Requirements (Please list items to be purchased and estimated costs)
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IV. Describe Remodeling Requirements and Cost Estimate
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V. Describe Plan for Continuing Costs Associated with Request, if Applicable.
Include software licensing renewals, software upgrades, maintenance fees, continuing services and supplies, etc.
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VI. What other funds will be used in this project? If Lab Mod Matching Funds are requested, what is the funding
source?
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VII. Pedagogical Rationale/Justification of the Request
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VIII. List of Courses to be served in Lab/Classroom
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IX. Statement on How Project Meets Needs of Students with Disabilities (Please consult with UW-Stout Disability
Services)
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X. Describe how the Access to Learning Laboratory Survey supports the request
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Laboratory Modernization Request Guidelines
These guidelines have been developed to assist requestors in submitting Laboratory
Modernization Funds Requests.
1. Request form must be complete
 All information must be provided, Numbers must add up correctly
 Estimates and quotes from all equipment/service providers must be included
 All lab mod requests to be submitted electronically to Lab Mod Coordinator in pdf
format
2. Utilize the Access to Learning Survey results if applicable. See results at:
https://info.uwstout.edu/UWStout%20Document%20Library/Surveys/Student%20Surveys/Access%20to%20Learning%20Ev
aluation%20%e2%80%93%20Laboratories/2011/AccesstoLearningEvaluation-LabratoriesFullReport20110301.pdf
3. Request can include initial software purchase, but continuing software costs are a
departmental expense
4. Maintenance agreement costs are not an eligible expenditure
5. Obtain vendor proposals for cost of equipment and utility service requirements
 Anticipate costs for purchasing after July 1 of the next year
6. Request Physical Plant cost estimate assistance
 Allow time for Physical Plant to provide cost estimate
7. Request Telecommunications & Networking (T&N) assistance
 Allow time for T&N to provide design and cost estimate
8. Request Learning Technology Services (LTS) assistance
 Allow time for LTS to provide design and cost estimate
9. Prioritization of equipment and service needs is strongly encouraged to minimize all-ornothing decisions
10. Requests should be submitted to Department Chair; Chair submits requests to Dean
11. Required signatures. Deadline at each level must be met.
12. Submit by due date to Lab Mod Coordinator. Late submittals will not be accepted.
Members of the ASA Space Committee are available to assist you if you have any questions
regarding your submission. Members include:
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Jim Guenther, ASA Space Committee Chair, Learning Technology Services
Glendali Rodriguez, Associate Vice Chancellor, Academic and Student Affairs
Lalia Rach, Associate Dean, COM
Robert Peters, Associate Dean, CEHHS
Rich Rothaupt, Associate Dean, CSTEM
Julie Watts, Associate Dean, CAHSS
Marlys Brunsting, Director, Robert S. Swanson Learning Center
Deb Shefchik, Dean of Students office
Larry Blackledge, Stout Technology Transfer Institute (STTI)
Kathy Sveum, Registrar’s office
Gary Gust, Lab Mod Coordinator