Branded Merchandise/SWAG Request Form
Please complete the form below to submit your request.
Name
Name
*
First
Last
Email
*
What Department are you with?
Leadership Team
Administrative Offices
Center for Research and Scholarship
Center for Rural Health
Enrollment and Student Services
Graduate Nursing
Kinesiology
Smart Hospital
Undergraduate Nursing
CIHI
Other
If you selected other, please fill in here:
Total quantity of items needed?
Does anything need to be ordered?
*
Does anything need to be ordered?
Yes
No
Do you need a logo?
*
Do you need a logo?
UTA logo
UTA CONHI logo
UTA CONHI Department logo
Other (specify below)
If you selected other, please describe here.
Is your requested merchandise being purchased with grant funds? If yes, we will reach out to you for written approval from your department Chair.
Is your requested merchandise being purchased with grant funds? If yes, we will reach out to you for written approval from your department Chair.
Yes
No
Please provide a summary of the event and type of items needed.
*
Maximum of
350
characters allowed.
Currently Entered:
0
characters.
Request date for items needed.
Request date for items needed.
*
/
MM
/
DD
YYYY
Sometimes we need to follow up with questions. Please provide a day/time that you may be available for a Teams call if needed.
Upload a file or image if helpful. (Can upload more than one).
Attachments should be PDF, jpeg, or png. Word document for text only not pics or graphics.)
Attach Files