Request for a new Printer / Fax / Copier

Date of Request:

Click here to enter a date.

Contact Information:

Requester Name	Phone Number	Email Address

Machine Location:

Facility	Building	Floor	Room

Machine Functions: (Check all that apply)

Machine Size: (Select one)

Printing Options: (Select one of each)

Enter justification for color machine here

Paper Sizes: (Check all that apply)

Enter custom paper size

Paper Trays: (Select one)

Finishing Options: (Check all that apply)

Machine Justification:

Enter Machine Justification here

Please submit to Chris Malena for CVH/RVS requests or Susan DePaolis for OOC requests.