Change Request Form 1. General Information Project name: Project number: Requestor name: Requestor's contact information: Date of request: Change request tracking number: Date request approved/denied: Section One-To Be Completed by the Requestor II. Description of Change Include a detailed description of the requested scope change. Request Ill. Business Justification for Describe how the business, project, or product will benefit from Change the requested change. IV. Impacts of Not Making the Describe how the business, project, or product will be Change impacted if the change is not made V. Alternatives to Change Describe any known alternatives to the change. Section Two-To Be Completed by the Project Manager VI. Impacts of the Describe the impacts of this change to the project schedule, budget, Change and quality. VII. Alternatives to Describe alternative solutions to the change. Change VIll. Recommendation to the Describe the project manager's recommendation to approve or Change Control Board deny the change. Include justification for the recommendation. Section Three-To Be Completed by the Change Control Board Recommendation: Include a discussion concerning the goals of the project. Does this change significantly Date of Review: Impact the goals of the project such that the project goals can no longer be met? Should this change be considered a new project or phase two of the existing project, etc.? Signature