Project Change Request Form

1. Project Change Request Form Project Change Request FormPurposeThe purpose of this tool is to standardize all Project Change Requests so that we canevaluate and prioritize requests appropriately to facilitate delivery.Change Requester InformationDepartment: Priority: High Med LowContact Name: Contact Email:Project Sponsor: Date:Project TitleCommunicate which project you would like to change the scope for.Scope ChangesBriefly document what deliverables you would like to add to the project plan and discuss thebenefits and value that this change adds to the project.Impact of Non-CompletionShould resources not be available for this scope change, describe how the business will beimpacted by non-completion of this proposed amendment.Impact on Project TimelinesEstimate how this change in scope will affect project timelines and end date.

2. Additional Resources Required • What resources will be required to complete this portion of the project? • What is the estimated cost to add this deliverable into the project?Project Change Request Approval (required signatures)Change Requester: Project Sponsor:Date: Date:Name: Name:Signature: Signature:Project Manager:Date:Name:Signature: Additional Resources Required • What resources will be required to complete this portion of the project? • What is the estimated cost to add this deliverable into the project?Project Change Request Approval (required signatures)Change Requester: Project Sponsor:Date: Date:Name: Name:Signature: Signature:Project Manager:Date:Name:Signature: