SURPLUS REQUEST CONTACT FORM

Item Information

* ITEM NUMBER

* Would you like to reserve this item? (Max. 1 week Reservation)

Yes

No

Date you can look at or pick up item? (Hours are M-F, 8-12 & 1-5)

Do you want us to Deliver this item? (On Campus Only)

Yes

No

If Yes:

Date
Time
Location

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

Additional Comments or Questions:

* Indicates Response Required

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