JOB#    

Requestor    Department      PS#       Phone# 
    Personal Work(To Be Billed To Individual/Organization)
        Name
   Address       Authorized Signature                                                                 
Test   Form   Syllabus   Letter/Memo   Course Material
    Date Required    COPY ON ONE SIDE ONLY   COPY ON BOTH SIDES
                                          Total Number of Pages (To Be Copied)        Number of Copies per Page 
    Special Instructions
    
          8.5 x 11         8.5 x 14     11 x 17         Paper Provided

     20# Paper          Cardstock*            Letter Head                     Envelopes*
     White                  White              Plain White Black Ink          Plain White Black
     Blue                     Cream             State Seal Black Ink             State Seal Black
     Buff                     Gray                 State Seal Black/Red            State Seal Black/Red
     Golden Rod         Ivory                Buff* Black/Red                    Buff* Black/Red
     Green                  Green
     Pink                    Golden Rod
     Yellow                                                                                     *Charged Against FRS Account
  Collate     Punch     Thermal Bind*     Staple     Cut     Fold     Pad
    Describe Specific Requirements
    
    Return Through Campus Mail   Will Pick Up
  Distribute To:     Administrators  Classified Employees  Faculty
                                Librarians           1 Each Department      Students(Fred. Hall)
    Finished Work and Received By:

                                                                                            Date                                         
IF ENCLOSED CONTAINS COPYRIGHTED MATERIAL:
NOTICE:Warning Concerning Copyrignt Restrictions
The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted material. Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy of other reproduction. One of these specific conditions is that the photocopy or other reproduction is not to be 'used for any other purpose other than private study, scholarship or research.' If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of 'fair use' that user may be liable for copyright infringement. This institution reserves the right to refuse to accept a printing order if, in its judgement, fulfillment of the order would involve violation of copyright laws.

This request complies with section 107 of the copyright law.                                                                                          
                                                                                                                             Signature of Instructor
**** Please print this form before submitting ****