Academic Technology Resource Center
Work Order Form
Date: Request Completion Date:
Name: Phone:
Email:
Course ID:
Course Name:
Work order complies with the “fair-use” (TEACH Act) of copyrighted material. YES NO
(For references, refer to http://fresnostate.edu/academics/cfe/resources/copyright.html)
SERVICES REQUESTED: (Please check all that apply)
Document Scan (OCR, PDF, JPG, PNG) Bb Course Content Manipulation
Image Scan (JPG, PNG, GIF) Exam / Quiz Generation
Media Content Creation Other:
List items and description of work order:
UPON COMPLETION:
Upload to Bb Course Email to Notify Instructor Call to Notify Instructor
Return via Mail Stop Shred / Destroy Save to External Device
Completed Work Approved / Picked Up: Date:
– RESOURCE CENTER USE ONLY –
By: Status: Date:
Completed By: Duration:
Completed Date:
Notified Date: Email: Phone:
