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Clicker Fraud Checkout Request Form
Please submit this form if you would like to use the clicker fraud devices in your classroom.
Title:
Name
First
Last
Email
Course:
Room and Building Number:
Date Requested
MM
/
DD
/
YYYY
If devices are needed for multiple days, please fill out a request form for each day
Date and time of pick up:
Subject to change based on office hours
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