diff --git a/.github/ISSUE_TEMPLATE/request.md b/.github/ISSUE_TEMPLATE/request.md
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+---
+name: Request
+about: This is a request for work
+title: '[REQUEST]: '
+labels: 'request'
+assignees: 'leohhhn', 'waymobetta'
+
+---
+
+### Department:
+<!--- Provide the department submitting the requesting -->
+
+### Deadline (est.):
+<!--- Provide the estimated deadline date -->
+
+### Summary
+<!--- Provide a general summary of the issue -->
+
+### Body
+<!--- Provide any supporting notes including examples -->