PURCHASE REQUISITION FORM
Complete the information and obtain approvals below. Forward the completed and approved form to the Purchasing Department, Mc Spedon Hall, Room 211. Forms that are not approved or incomplete will be returned to the requisitioner. All inquiries may be directed to ext. 2246. Do not use this form to order stationery, furniture or general office supplies.
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Requisitioner Info: |
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Recommended Vendor Info: |
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Date |
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Name |
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Name |
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Address |
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Department |
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Phone |
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Delivery Location |
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Phone |
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Center & A/C # |
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Fax |
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PO# or VISA |
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Attn: |
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(Internal Use Only) |
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Item # |
Quantity |
Description |
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Unit Price |
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Total |
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Special Instructions:
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Department Approval: |
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Dean/VP Approval: |
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Signature |
Date |
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Signature |
Date |
Purchase Requisition 03-12