------------------------ Online Order Form --------------------------
Today's Date:
Today's Date
Contact Information ------------------------------------------------
Department:
If your department is not listed or is incorrect, please select other and complete the text box below. Other:
Name of department if not included in list above or if incorrect. Contact Name:
Name of person to contact for questions. Contact Email:
Contact Email Address. Phone Number:
Please enter contact phone number.
Order Information ---------------------------------------------------
Mailing Date:
Please enter requested mailing date. Job Description:
(Example: Business Cards - Allen Vervisch, Letterhead, Envelopes) Quantity:
Enter number of pieces to be mailed. # of Pieces:
Please enter number of pieces to be stuffed in each piece of mail.
Mailing Information--------------------------------------------------
Mailing Work:
Please select all that applies.
Bindery Information ------------------------------------------------
Bindery Work:
Please select all that applies.
Pickup and Delivery Information ------------------------------------
Select One:
Please Select one, if you select delivery, please indicate the room number and building where you would like the completed job delivered to.
Room/Building:
Please enter room number and building for delivery.
Billing Information --------------------------------------------------
Payment Type:
If you are paying with cash/check or this is a direct bill, please enter the appropriate number of 0's in account information below.
Select One:
Fund:
6-Digit FUND number (xxxxxx-000000-00000-0000-000000) Organization:
6-Digit ORG number (000000-xxxxxx-00000-0000-000000) Account:
5-Digit ACCOUNT number (000000-000000-xxxxx-0000-000000) Program:
4-Digit PROGRAM (000000-000000-00000-xxxx-000000 Activity :
ACTIVITY (000000-000000-00000-0000-xxxxxx) Approval:
You will receive a proof prior to printing if applicable. Your account will not be charged until the job is complete.
Instructions:
Please indicate your special instructions here. (e.g.. File name, uploaded file to server, request for pickup of samples, CD's, etc)