Authorization for Printing
Health Sciences Center
Notesheets




This form must be received before any work can begin. Any changes to this order must be in writing. A job number will be assigned to this request and an acknowledgement of order sent to you.

Click here to see a sample.

Small Notesheet (4.25" x 5.5")
Large Notesheet (5.5" x 8.5")

This is a reprint with NO changes.

Type in text exactly as you wish it to appear OR you may FAX a sample. If you choose to fax a sample put "sample is faxed" in the first text area.

Name:

Title:

Department:

Address:

Phone: FAX:


Contact Person:

Date:

Phone:   Fax:

Department to be billed:

Account #:

Do you want this order shrink wrapped? Yes No

Padded? Yes No

(How many per package and pad?)

Quantity (minimum order 500):

Date Requested:
      (subject to production scheduling)

Do you want to proof this job before it is printed? Yes No

Fax proof? Yes No

Proof fax #

Deliver proof? Yes No

Deliver proof and finished product to same location? Yes No

Proof Delivery Location:
Room #

Finished product delivery information:
(If different from proof delivery location)
 Room#

Delivery contact person:

Telephone #

Any additional comments, information or instructions?


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