Request for Prepaid Departmental Copy Card

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 copier machines in the Periodicals section.
Departmental Copy Cards are for use in official University business only.
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 )
Number of copies per card:
( $0.10 per copy )
Bill to account number:
Authorized Signature:
Your Email Address:

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