University of Illinois at Rockford - College of Medicine

Contact Information

Department Name: 

Contact First Name:   Contact Last Name: 

Title: 

Email Address:

Office Address:  

Phone Number:  

FOAPAL #:  

Final Approver Name: 

 

Project Overview

Project Requested:

Date Due:   Would you like an estimate:Yes No

Is this a reprint?:Yes No

Project Description

(please provide as much detail as possible):

Target Audience (check all that apply):
 Alumni    Community Members    Donors    Faculty and Staff

 Patients    Providers    Students

Other, please specify:

Finishing

Quantity of the finished product needed:   

Total No. of pages per piece (duplexed pages count as two pages): 

Color: Black & White    2-Color    4-Color

Finished Size:scroll down to select size5 x 78.5 x 5.58 x 108.5 x 118.5 x 1411 x 17other   Other Size Not Listed:

Folding Required: Yes  No

Does the project need to be mailed by a mailing service?: Yes  No

Special Instructions(binding, cutting, laminating, mounting, etc.):