Supply Request From 221-b

[large]Supply Request Form 221-b[/large][br][hr]What is your name and rank?[br]Name:[field][br]Rank:[field][br][hr]What item(s) are you requesting?[br][field][br][hr]What do you need these items for?[br][field][br][hr]Delivery by Mulebot, Mail system, or Pick-up?[br][field][br][hr]Notify by Radio, PDA, or None?[field][br][hr]If additional authorisation is required*, please have the appropriate head of department sign or stamp below:[br]Please sign here:[field][br][hr][small]By signing this you agree to not hold Nanotrasen Supply Services or any of its employees responsible for any harm, real or perceived, from our services.  Nanotrasen Supply Services reserves the right to refuse service without reason.[br]*Additional authorisation may be required when items are too expensive, or too dangerous for an unqualified employee to carry.[/small]