You are here: Request for service form
Required Fields *
* Request for Quote:
* Request for Service:
* Name:
* Dept / Company id:
*Email:
* Telephone:
Fax:
* Type of Service:
* Requirements:
List all details of your requirements here. Any material that needs to accompany this request should be forwarded to:
Division of Teaching and Learning Services (Building 37) Central Queensland University Yaamba Road, Rockhampton, Qld 4702.
or email to DTLS(accompanying material).
Completion Date: (yyyy-mm-dd)
CD Requirements (only required for CD Replication)
Internal Duplication
Standard CD wth PVC Wallet (Black on Silver) Non-Standard CD Paper Insert
External Duplication/Replication
Labels:
Black & White / Silver (not available - done internally instead) 3 Colours 4 Colours
Packaging:
Clear Plastic Wallet Card Wallet Jewel Case Slimline Jewel Case
Artwork:
Paper Inlay for Jewel Case Artwork for Card Wallet
Address for Account - If external to university, please provide details
Name:
Address:
Postcode:
Choose either CQU Recharge or Faculty/Divisional Allocation
CQU Recharge A/C:
Faculty/Divisional Allocation:
* I have the authority to commit allocation/funds:
Yes
No — If 'No' please provide details of authorising agent
Position:
Phone:
Email:
