FS-2                     TJN.Lvr.HSXTY or   Al RENO
        (8/93)                            1995-97
        Page 1                 BXENNXAL CAPXTAL REQUEST FORK

        Please return by e%              to:
        Facilities service@s/114
        Mackay Science, Room 204

                                                  For Office U96 Ofil@l

                                               FP & M Board
                                               Univ.  Admin.
                                               Bd of Regents
                                               Status

        SCHOOL/COLLEGE:                                   PRIORITY:
        Please provide a brief tltle (e.   "storage room" 0  "research
        facility"), of each request along with a description of  your
        capital request.  Use a separate copy of this  form  for  each
        request and assign a Priority number for each form submitted.
        Attach additional sheets as required to answer each section.

        TITLE DESCRIPTION:

        REMODEL:     I I                   COST ESTIMATE:
        NEW FACILITY: C j    TOTAL USABLE SQUARE FOOTAGE:

        PREVIOUSLY REQUESTED?  YES      NO          WHEN:

        LOCATION (site or building):

        Department (if applicable):

        Room Number (if applicable):

        PROPOSED FUNDING SOURCE AND ESTIMATED AMOUNTS FROM EACH:
        State          Federal             Private             Other C

        ANTICIPATED INCREASES IN STAFFING/OPERATING REQUIREMENTS:




        PROJECT DESCRIPTION (required relevant data to describe project):

         FS-2                      UN@SITY OF         A,, RENO
         (8/93)                             1995--97
         Page 2                  DIENNI" CAPITAL REQUEST FORM

         PROJECT JUSTIFICATION:








         IMPACT  ON   EXISTING   FACILITIES   (reutilization,    renovation,
         demolition):








         COMPLIANCE WITH ACADEMIC AND/OR FACILITIES MASTER PLANS:








         NOTE: If you have any questions or  require  any  assistance  in
              the completion  of  this  form,  please  call  Gary  Bishop
              (6948)  or  come  by   the   Facilities   Services   Office
              located in Mackay Science, Room  204.  All  forms  must  be
              signed by the appropriate Dean and/or Vice President.



         originating Department Chair o  i@r.                     Date



                         Dean                                    Date



                   Vice President                                Date