Purchasing Card Request Form

Student Activities / TRIO Purchasing Card Request Form

This form should only be used for student activities related transactions
You will this form to request to utilize a Student Activities Purchasing Card to make credit card purchases on approved expenses or travel.

When you submit this form it will send you an email with a copy of the Student Activities Credit Card Purchase Form. You can print this and bring it with you to pick up the credit card or you can have it printed in the Student Activities Office.

Note: Richard and Shane are the only two that can access the responses to this form. Please plan ahead to ensure we are available to get you the credit card.

Questions? Email Richard, rarquette@lowercolumbia.edu
Todays Date*

MonthDayYear
Date
Old Name (dont delete)*
Club / Organization / Department Name*
Other? Write department/club/org name below:
First & Last Name*
Email*
example@example.com
Vendor Name(s)*
You can list multiple, but provide more information in the explanation box on the additional vendors
Total Expected Budget Amount
Calculated $ amount*
Explanation of Purchase*
Please describe what you are expecting to purchase with the card to help us with tracking if a receipt gets lost or misfiled
Should be Empty:

Student Activities / TRIO Purchasing Card Request Form