Please allow 3-5 business days for the Mobile Pay to be set up after your submission.
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Department
*
Event Details
Is this a donation event?
*
Yes
No
Description of the Event
*
(Please provide detail)
Start and End Date of the Event
*
(If this is a One Day event, you can enter that date only. If multiple days, please list exactly how many days.)
Fund/Org/Acct
*
(Must be in this format - xxxxxx/xxxx/xxxxx)
Equipment Pick Up/Return Information
Please plan to pick up at least 1 business day prior to the event date.
Pick up person
(Only if different than the contact person)
Pick up Date
*
-
Month
-
Day
Year
Date Picker Icon
Return Date
*
-
Month
-
Day
Year
Date Picker Icon
Any comments/special requests?
Mobile Pay Equipment Loan Agreement
By checking the boxes below, you are in agreement of the following statements.
*
I agree to return equipment to the Controller's Office by 3:00pm on the business day after the event ends.
I agree to use this device for purposes of using Bank of America Mobile Pay/Clover Application solely.
I will not install any software/application on this device.
I assume full responsibility for the equipment while it is loaned to me and will immediately report lost or stolen equipment to both the IT Service Desk (4957) and the Controller's Office (#1098).
I agree to ensure the event money is deposited to the correct Fund/Org/Acct.
I agree NOT to share this device with anyone else (even if we are in the same department).
Submit
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