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Students.

Campus Connection Request Form

CAMPUS CONNECTION MESSAGE INFORMATION FORM
All inquires and questions should be mailed to

MESSAGE DEADLINE IS 10:00 A.M. FIVE WORKING DAYS BEFORE BEGINNING DATE
**Note all fields are REQUIRED unless marked otherwise!.

General Contact Information
Submitted by:
Phone#:
Your Email Address:

Date Information
Begin Date (mm/dd/yyyy):
End Date (mm/dd/yyyy):
Total # of Days:

Slide and Billing Information
Purpose of Message:
Bill to:
Phone:
Address:
Department:
Account Number: (For departments only)


Please indicate your message with desired size, color of font, and background color in the space provided below.

AVAILABLE FONT SIZES: small, medium, and large
AVAILABLE COLORS: all colors of the rainbow
HELPFUL HINTS: Use light text on a dark background. Red text looks best on a white background. Please limit message minimum font size to 28 bold. The fewer the words, the larger the font size can be.

Special Accomidations Phone #:

Anti-SPAM Code This box must be left blank to submit this form. If you enter anything into this box, your form will be rejected.