EmailMe Form - Digital Display Request Form

Name *
First Last
Title *
Department *
UNCG Email Address *
Phone *
### - ### - ####
Title of Ad *
*

Add File

All files must be a .jpg or .png format, 1920px wide x 1080px high, at 72 DPI. HRL is not responsible for image design. Multiple images may be attached.
Start Date to Display Advertisement *
MM / DD / YYYY
End Date to Display Advertisement *
MM / DD / YYYY