Improvement Request Form

1

Brief description of area of improvement needed

Brief description of area of improvement needed

2

Waste – choose all that apply 

 *

Waste – choose all that apply

Over Production (producing too much or too soon)	Waiting (idle time)
Transport (moving information)	Motion (people)
Over Processing (too many steps to do a job)	Inventory (too much stock or work on hand)
Defects or Rework (poor quality)	Waste of Intellect (missed opportunities – people and processes)
Waste of Energy (heating, cooling, lighting, office equipment, etc.)

3

This effects – choose all that apply 

 *

This effects – choose all that apply

Me only

Some staff

Most staff

Staff and students

4

Estimated time spent

 *

Estimated time spent

This takes a little time, frequently

This takes a lot of time, occasionally

This takes a lot of time, frequently

5

Which of the BMCC Strategic Plan goals do you think this project would support, choose all that apply

 *

Which of the BMCC Strategic Plan goals do you think this project would support, choose all that apply

Students First – BMCC is Committed to Promoting Equity in Success for All Students	Current and Comprehensive BMCC Marketing, Communication, and Recruitment Plan
Relevant, Dynamic, and Diverse BMCC Curriculum	Appropriate Technology with Robust and Sustainable Infrastructure at BMCC
A Safe Environment for All at BMCC	Welcoming, Well-Maintained and Safe Facilities and Grounds at all BMCC Locations
Diverse and High Quality Internal BMCC Workforce	Deliberate Continuous Improvement Based on Evidence at BMCC
Stable, Flexible Financial Plan that Supports the BMCC Strategic Plan

6

Has the staff responsible for the process been made aware of your concern and intent to complete this form? 

Has the staff responsible for the process been made aware of your concern and intent to complete this form?

Yes	No
If Yes, Enter Staff person name here

7

Are you willing to take the lead on this Lean project 

 *

Are you willing to take the lead on this Lean project

Yes

No

Maybe

8

 Personal Information Below

Personal Information Below

Name

Phoneext.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

Page 1 / 1