The University of Memphis

REQUEST FOR AUTHORIZATION
TO DISTRIBUTE LITERATURE
BY NON-STUDENT ORGANIZATIONS

Return form to the office of Business Services, Admin Bldg, Room 371
Permission is not granted until this form has been returned to the office of Business Services and has received the final approval from the Assistant Vice President for Business Services.
Name of Applicant:
Organization/Publisher:
Address (line 1):
Address (line 2): 
City:
State:
Zip/Postal Code:
Phone:
Description and/or sample of literature:

PLEASE ATTACH A COPY OF LITERATURE TO BE DISTRIBUTED

How is the literature to be distributed:
Is literature to be sold? yes no  If so, how much per copy?
Date distribution desired: Time:  From To
Date distribution will be removed from location:
Location(s) desired:
Number of Participants:
Name and Address of Participants:
The University of Memphis, one of the Tennessee Board of Regents institutions, is an Equal Opportunity/Affirmative Action University.