Technology/Mileage Request Form -- UT Arlington: Fort Worth Center

Technology/Mileage Request Form

Contact Information

Your Name:

Daytime Telephone Number:

Campus Box #:

Email Address:

Technology Request

Program that will be presented:

Requested Pick-Up Date:

Requested Return Date:

Do you need us to loan you any equipment? (Check all that apply)

Overhead Projector

LCD Projector

Extension Cord

Laptop Computer

Slide Projector

Other:

Reimbursement for Mileage Request*

Date of Presentation:

Starting Address:

Name of School:

School Address:

Beginning Odometer Reading:

Ending Odometer Reading:

*Mileage reimbursements will be processed in accordance with all applicable regulations as provided by UTA's Handbook of Fiscal Regulations and Procedures.

You will received an email from department personnel confirming the receipt of your request. If you do not receive confirmation within two business days, please contact Megan Topham at extention 25908 or utafw@uta.edu.

Please note, it is only necessary to click the "Submit" button once.