Request for Prepaid Departmental Copy Card
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Please fill out this form to receive a departmental
photocopy card. This card will enable you to use the card-operated photocopiers in Kent Library at the copiers in the Periodicals section. Departmental Copy Cards are for use in official University business only. |
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| Please complete this form and return it to the Information Technology Help Desk located in Memorial Hall (Room 101). Cards may also be picked up at the Help Desk. | ||
| Name of Department: | ______________________________ | |
| Number of cards requested: ( $2.50 per card ) |
______________________________ | |
| Total for cards purchased: | ______________________________ | |
| Number of copies per card: ( $0.10 per copy ) |
______________________________ | |
| Total amount including cards and copies: | ______________________________ | |
| Bill to account number: | ______________________________ | |
| Authorized Signature: | ______________________________ | |
| Card(s) Received by: | ______________________________ | |
| Date: | ______________________________ | |