copy center request form

							  DATE IN:
                                COPY CENTER REQUEST FORM                                                          JOB #
                                        Printing Services Copy Center

         AUTHORIZED SIGNATURE                               PRINT NAME                      COST CENTER       EXTENTION #        FAX #



                            REQUESTED BY                                 DATE REQUESTED             DATE REQUIRED
                                                                                                                              A.M.
                                                                                                                              P.M.
                              DEPARTMENT                                                       INSTRUCTIONS
                                                                              Collate (Free if done on copier)
  BLACK & WHITE COPIES                     COLOR COPIES                       Staple Upper Left
      One Sided                          One Sided                            3-hole Paper
      Two Sided                          Two Sided                            Colored Paper
  SIZE:                              SIZE:                                    Covers
      8 ½ x 11                           8 ½ x 11                             GBC Bind
      8 ½ x 14                           8 ½ x 14                             UniBind
       11 x 17                            11 x 17                           Fastback Tape Bind
       Portrait                           Portrait                          Plasticoil
       Landscape                          Landscape                         Other
   NO. OF ORIGINALS     NO. OF COPIES PER ORIGINAL      TOTAL COPIES     Copy Charge

                                                                         TOTAL CHARGES                                    $



  NOTES:




  ORIGINAL TYPE:           PC       MAC        E-COPY-UTD            HARD COPY           EMAIL

  FILE NAME:


 COPYRIGHT NOTICE: The copyright law of the United States governs the making of photocopies or other reproductions of copyrighted materials.
 The Copy Center reserves the right to refuse to accept copying orders if, in its judgment, the copyright law would be violated.

                                                                                                                 DELIVERY LOCATION



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 RECEIVER’S SIGNATURE


 REVISED: 02/22                                                                                     ORIGINAL TO COPY CENTER – BK11