Requested Change Form

Name of person submitting request:
Name of Company or University of Illinois Department:
Your e-mail address: We will use this e-mail address to follow up with any questions we may have, and will also use this e-mail address to inform you of the results of your request.
Your phone number:
Location of Proposed Change (provide document name, paragraph number, etc. as appropriate):
Delete the following words:
Add the following words:
Reason for the Request:

Thank you for your feedback. We will evaluate your request and will let you know what action we will take as a result of your request.