Academic Breakout/Event

This form should only be used for events with the following attributes:
  • Needs to be in a classroom or computer lab (not a conference room)
  • Directly connected to a class
  • Happening during the first 3 weeks of class in a semester (Use 25Live for any requests beyond that)
  • Sponsored by the Department

Please see the Schedule Forms page for directions on how to make other schedule changes. The submitter's email listed below will be sent a confirmation email after submission.

This form is to ONLY be filled out by Academic Coordinators or Department Chairpersons (This is NOT a student form).

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Be Descriptive (example: Breakout Study Session for CHEM 105L)
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for example: 101, 450B, or 599
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2 digit section number
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CRN (5 digits)


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Let us know if you want a particular room or building
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Anything extra we should know about your event
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Submitter's Full Email (jsmith@csusm.edu)

Anyone who you would like us to Carbon Copy when we Respond
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SUBMIT