88.3 FM WXUT
REMOTE INVOICE and DJ Service Verification
University of Toledo
2801 W . Bancroft St.
MS# 118, SU Room 2515
Toledo, Ohio 43606
PH: 419-530-4172
TO BE COMPLETED BY THE REQUESTING DEPARTMENT/ORGANIZATION:
Today’s Date:
Requesting:
WXUT Service –or–
Waiver
Requesting Department/Organization:
Dept./Org. Representative:
Phone number:
(
)
Position/Title:
-
Email Address:
Name of Event:
Date of Event:
Day of Week
Time of Event:
Month
am /
Day
pm
Location of Event:
Description of Event /
Special Instructions:
Year
to
am /
pm
Type of Music:
Method of Payment: UT Budget Index and Account Code to be Charged:
Departmental
Authorized Signature:
Print Authorized Name,
Department & Title:
Date
or Check Number on Payment (Attached):
Upon receipt you will be contacted via the email address provided above. Thank You & Go Rockets!!!
Determination to be completed by WXUT Representative:
WXUT is NOT available to provide DJ services for this event on this date.
OR
WXUT is available and will provide DJ services for this event on this date.
Costs:
Please check one: Setup/Epuipt. Fee
$ 50 - UT Student Org
$60 - All Others
DJ Fee $10.00 per hour:
X Number of DJs
X Number of Hrs
=
(Additional charges for Karaoke services)
From
to
DJ (s) Assigned to Event:
DJ Email
WXUT Representative:
PLEASE MAKE CHECK PAYABLE TO: University of Toledo-WXUT and forward to:
University of Toledo
2801 W. Bancroft St.
MS# 105, Attn: Geni Hofbauer
Toledo, Ohio 43606
$
Number of DJs:
TOTAL DUE TO WXUT #A10410
DJ Phone number:
$
Date
$