Directions for completion:
- Complete all of the information on the form. For additional instructions, double click on the question marks on the PDF.
- Print one copy to sign and send to EH&S and print one copy to keep for your records.
- Fax or mail the completed Recharge Authorization Form to the Office of Environment, Health & Safety.
FAX number: 643-7595
Campus Address: EH&S, University Hall, Room 317, MC 1150
Questions about this form or your recharge account?
If you have any questions, please contact the Recharge Administrator at 642-3073 or e-mail at email@example.com.