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Welcome to the Creative Media Center job request form
Please provide some basic information to get started. * Denotes a required field. After you are done filling out the form, please click the submit form button. You will then see a message that the project has been successfully submitted and receive an email confirmation shortly. For questions regarding our timeframes, prices and how to work with us, see our related links on our university homepage. If you are experiencing problems with this form please contact us at 847-578-8814
Contact Info
First Name *
  		Last Name *
 
Phone number (extension) *
 
Email *
   
College *
 
Department *
What Service(s) are you requesting?


For Event Photography and or Videography Only
Event Name
Event Location
Contact Person's Name
Contact Person's Cell Phone
Event Start Time
Event End Time
Service Start Time
Service End Time
Event Date
Total Photos Needed
Project Information
Job Name * (Please provide a simple and short name for your project)
 
Notes (Please provide us with the project details here. or type "request a meeting" for a complex project)
Payment Method
(One Rfums account number only, its format should be as shown 00-00-000000-000000-00000)
Payment Type
I have a file to upload (Before you upload a file, you need to fill in the above required fields)

                         
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Rosalind Franklin University of Medicine and Science - 3333 Green Bay Rd, North Chicago, IL 60064    (847) 578-3000