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Note to Applicant:

Once this has been signed and reviewed by all you will receive an e-mail with the completed form and notes from Procurement as to whether or not it has been approved.

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Signature HereDepartment Head Will Sign Here

03/29/2026

Signature HereGloria Pargas Will Sign Here

Signature HereClick to Sign

03/29/2026

03/29/2026Click to Sign

Signature HereAndrew Valencia Will Sign Here

03/29/2026

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Other Signers (The signers below will be invited to sign once the above signers have signed.)

	Andrew Valencia
	Gloria Pargas