Person requesting* First Last I am a:*DMU EmployeeDMU StudentPlease note: All student requests must first be approved by Student Affairs.Department*AccountingAdmissionsAnatomyAnimal Care FacilityBasic Life SupportBehavioral Medicine, Medical Humanities and BioethicsBiochemistry and NutritionBiomedical Sciences ProgramCenter for Teaching and LearningClinicCollege of Health SciencesCollege of Osteopathic MedicineCollege of Podiatric Medicine and SurgeryCOM Academic AffairsCOM Clinical AffairsCommunity RelationsComplianceContinuing Medical EducationDepartment of Public HealthDevelopment and Alumni RelationsEnrollment ManagementExternal and Government AffairsFamily MedicineFamily Medicine ClinicFinancial AidFoot and AnkleGlobal HealthHealth Care Administration ProgramHEARTland NetworkHuman Performance LaboratoryHuman ResourcesInformation Technology ServicesInternal MedicineLibraryMarketing and CommunicationsMicrobiology and ImmunologyMulticultural AffairsNutrition and Dietetic ServicesObstetrics and GynecologyOsteopathic Manual Medicine ClinicPediatricsPhysical Medicine and Rehabilitation ClinicPhysical Therapy ProgramPhysical Therapy ClinicPhysician Assistant ProgramPhysiology and PharmacologyPresident’s OfficeProvost’s OfficePublic Health ProgramRadiologyRegistrarResearchSpecialty MedicineSimulation CenterStandardized Performance Assessment LaboratoryStudent Counseling CenterSurgeryStudent AffairsUniversity ServicesWellness CenterOtherDepartment (if not listed above)Phone*Email* Project name*Type of project*NewReprintRevision/updateServices requested* Digital signage Email Print Video Web or web form Other AudiencePurposeProject notesAttach any related files Drop files here or Attach a file (old)Accepted file types: jpg, png, pdf, ppt, pptx, doc, docx.Digital signage requestedRequested start date* Digital slide will be posted on this dateRequested end date Date slide will be taken downNotesEmail services requestedDate you would like email services completed* We cannot guarantee completion of projects without at least two weeks advanced notice. NotesPrint services requestedDate you would like print services completed* We cannot guarantee completion of projects without at least four weeks advanced notice. Approximate budget* Account number to be charged*Quantity*Auxilary pieces Reply card Envelope Reply envelope Other Other auxilary pieces*Distribution Handout Posted Mailed, handled by department Mailed, handled by marketing Other Other distribution*PostageFirst classBulk third classNotesVideo services requestedDate you would like video services completed* We cannot guarantee completion of projects without at least four weeks advanced notice. NotesWeb services requestedDate you would like web services completed* We cannot guarantee completion of projects without at least two weeks advanced notice. NotesOther services requestedDate you would like other services completed* We cannot guarantee completion of projects without at least two weeks advanced notice. Notes* This iframe contains the logic required to handle Ajax powered Gravity Forms.