Troy State University

Center for Continuing Education

Program Needs Form

Instructor Name

Address

Phone

Instructor’s Supply List

Student’s Supply List

Audio/Visual Equipment Needs

(please list any and all equipment needed for this course and date(s) required)

Room/Space Requirements

(please list any special needs required for your classroom in order to make room assignments)

Facility requests for rooms and equipment should be

placed through the Trojan Center Director’s Office.

Program Needs Form should be returned to the Program Sponsor.