IMC Photo Intake Form

IMC Photo Intake Form

Type of Request*

Select

Is this due date less than 6 weeks out?

Requester's Name*

Email Address*

Phone Number*

Requester's Department*

Department Sponsoring Event*

Chart String*

Name of Event*

Event Date*

Event Start and End Time*

Event Location*

Please include name of location and room number.

Event and photo coverage description*

Photo Usage*

Select

If facutly, name of faculty*

Write NA if not applicable.

If event, name and date of event*

Write NA if not applicable.

Where will photo be used (URL)*

Deadline Requested*

Relevant File Upload*

Please upload any relevant files such as schedule, or event details.

Drag and drop files here or

Send me a copy of my responses

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