Name ___________________________________________________________________ Telephone Number ___________________________________
E-mail ___________________________________________________________________
Date Work Submitted ________________________________________________________ Date Work Needed ___________________________________
ALL THESIS COPIES WILL BE PRINTED ON ACID-FREE PAPER.
Unless otherwise specified each bound copy will have a clear plastic front cover and black linen back cover.
Please check one: o Print in B&W
o Print in Color
Electronically Sent Filename ___________________________________________________________________
UNBOUND Thesis: $4 EA Quantity _________________________________________________________
VELOBOUND Thesis: $6 EA Quantity _________________________________________________________
Special Instructions ________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P R I N T C E N T E R U S E O N L Y
Paid: o Cash o Check # __________________________ Rcvd. by _________________ Cost $ ___________________________
o Credit Confirmation # _________________________ Credit Card fee 2.5% (if applicable) $ ___________________________
TOTAL $ ___________________________
Velobind Colors
Unless you specify black will be used
o Black
o Red
o White
o Navy Blue
o Green (Velobind only)
o Dk. Grey (Velobind only)
o Lt. Grey (Velobind only)
o Burgundy (Velobind only)
o Brown (Velobind only)
o Tan (Velobind only)
04/13
SENIOR THESIS PRINTING REQUEST FORM
Please include your name in the
filename of your document.
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