Purchase Request Form

Please submit this form AT LEAST 2 weeks in advance. Please keep in mind that Amazon Prime packages might take longer than two (2) days to arrive. Packages first get delivered to Postal & Print, then to the Meyerhoff package room, then to the CSE.

Student Organizations:

Purchase Requests will be denied if you have not submitted your budget and/or you do not have the funding
Purchase Requests are reviewed on Mondays of each week. Additionally, please check your budget before requesting any purchases.

Purchases may be denied if they are not submitted AT LEAST 2 weeks in advance.

Organization Name*

If Other, please provide your organization name. *

Which Student Org are you representing?*

Activity / Event Name*

For purchases unrelated to a specific activity / event, please list "General Operating."

Date of Activity / Event*

Date of Activity/Event

Date

Today's Date (used to verify 2 week rule)

Date

Date Calculation (used to verify 2 week rule; date of activity - today's date)

Hold on!

Your event is less than two weeks away! Please keep in mind that if you choose to proceed, you are risking your purchase not making it in time, and you will need to use this purchase for another event!

I understand that I am submitting this form with less than two weeks notice, and understand that there is a risk of items not making it in time if delivery is involved.*

I understand

Your Name*

First NameLast Name

Your Email*

example@mica.edu

Preferred Delivery Date

If you need your order by a certain date, please indicate that here.

Pick-Up Contact*

First NameLast Name

Pick-Up Contact Email

example@example.com

Phone Number*

Please enter a valid phone number.

Delivery Address*

Deliver to the CSE Office (we will contact you for pick-up)

Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Delivery Instructions (optional)

Additional instructions (security code, call box number, etc.) or requests for delivery driver.

Are you ordering from Amazon?*

YesNo

How would you like to submit your order?*

I'll provide an Amazon Wishlist (preferred!)I'll provide a list with links

Amazon Wishlist URL

Visit the Amazon Help & Customer Service page for more information about creating and sharing a Wishlist: https://www.amazon.com/gp/help/customer/display.html?nodeId=GPWMKQXXSBT8NAHN

Do you have any additional purchases you would like to request from a different retailer?*

YesNo

Order Details

Total Estimated Cost of Order*

Cost should take into consideration tax and delivery. Prices can sometimes vary between the time this form is submitted and when your order is being placed. CSE will contact you before ordering if the final cost is significantly higher to confirm if you want to proceed.

Attachments

Upload any applicable files.

Additional Comments

Use this space to share any additional information, including any discount/promo codes you would like to use, or if this order is time sensitive given a current sale.

CSE Purchase Request Form

Order Information