Smart Room Request Form

Prairie View A&M University

Wilhelmina F. Delco Building
P.O. Box 519; MS 2400,
Prairie View, Texas 77446
(936) 261-3600

1.	Today's Date

Department:

Class Name

Name

Email Address

No. of Undergraduates

No. of Graduates

2.	Please select room preference:

220	240
Requested Date(s) & Time(s):

3.	Will you need a technician?

Yes

4.	Provide Details

Learning Outcomes: (List at least 4)

How will the smart technology be used to enhance candidate’s knowledge, skills and dispositions?

If your request is approved, candidates are required to complete a technology survey