This form must be submitted at least 1 business day prior to the requested move date. Employee Information Please enter the information for the employee who is moving Name * Email Address: * Extension: * Move Details Move Date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020 Estimated Move Time: * Old Location Information Building: * - Select -999 E. Chicago - (M999)A.A. Smith House (H28)Benedetti-Wehrli Stadium (STAD)Boilerhouse Café (RC)Carnegie Hall (C)Fine Arts Center (FAC)Geiger Hall (GR)Goldspohn Hall (G)House - 109 S. Loomis (H109)House - 116 S. Brainard (H116)House - 119 S. Loomis (H119)House - 125 S. Loomis (H125)House - 224 E. Chicago (H224)House - 225 N. Loomis (H225)House - 322 E. Van Buren (H322)House - 330 E. Van Buren (H330)House - 48 E. Jefferson (H48)Kaufman Dining Hall (K)Kiekhofer Hall (KH)Kimmel Hall (KL)Kroehler Hall (SC)Larrance Academic Center (LAC)Meiley-Swallow Hall (MS)Merner Field House (MF)Naper Place (NP)New Hall (NH)Oesterle Library (LIB)Old Main (OM)Oliver Hall - (WONC)Patterson Hall (PRH)Pfeiffer Hall (PH)Rall Hall (RL)Rall House - 329 S. Brainard (H329)Res Rec (RRC)Schneller Residence Hall (SSH)New Science Center (STEM)Seager Hall (SR)Student Village (SV)Ward Hall (WH)White Activities Center (WAC) Room #: * New Location Information Building: * - Select -999 E. Chicago - (M999)A.A. Smith House (H28)Benedetti-Wehrli Stadium (STAD)Boilerhouse Café (RC)Carnegie Hall (C)Fine Arts Center (FAC)Geiger Hall (GR)Goldspohn Hall (G)House - 109 S. Loomis (H109)House - 116 S. Brainard (H116)House - 119 S. Loomis (H119)House - 125 S. Loomis (H125)House - 224 E. Chicago (H224)House - 225 N. Loomis (H225)House - 322 E. Van Buren (H322)House - 330 E. Van Buren (H330)House - 48 E. Jefferson (H48)Kaufman Dining Hall (K)Kiekhofer Hall (KH)Kimmel Hall (KL)Kroehler Hall (SC)Larrance Academic Center (LAC)Meiley-Swallow Hall (MS)Merner Field House (MF)Naper Place (NP)New Hall (NH)Oesterle Library (LIB)Old Main (OM)Oliver Hall - (WONC)Patterson Hall (PRH)Pfeiffer Hall (PH)Rall Hall (RL)Rall House - 329 S. Brainard (H329)Res Rec (RRC)Schneller Residence Hall (SSH)New Science Center (STEM)Seager Hall (SR)Student Village (SV)Ward Hall (WH)White Activities Center (WAC) Room #: * Equipment Information CPU NCC Tag #: * Monitor NCC Tag #: * Additional Instructions: Please list any additional hardware that needs to be moved or any special instructions.