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Departmental Copy Card

Campus Card request form

Departmental Photocopy Card

Name:

Department:   Contact Name:

Number of Cards to be issued:    Value of each card:

Grant Holders Name:

FUND:    ORGANIZATION:    ACCOUNT:    PROGRAM:

Indicate the location or locations where the card(s) is to be used:   
All locations open to faculty and Staff    Specific Location

Location:


the cards may be replenished at any time to departmental approval.

I acknowledge responsibility that all expenditures are valid, in compliance with the policies of the University and that sufficient funds are available to cover this expenditure.



Date    Name of approver:


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