Purchasing Requisition

2. Requesting Supervisor*

3. Department*

4. Cell Phone

6. Please select your need

   1. Please TEXT me a PO Number
   2. Please EMAIL me a PO number
   3. PCard Purchase. Please increase my PCard limit for single purchase

8. Vendor*

9. Address (if new)

11. City*

12. State*

13. Zip

15. Vendor Contact

16. Vendor Phone

18. Vendor Email

20. =========================================================================

22. Reason for Purchase*

24. Items You Intend to Purchase

26. Description 1*

28. Quantity*

29. $Each*

30. Total$*

31. GL

33. Description 2

35. Quantity

36. $Each

37. Total$

38. GL

40. Description 3

42. Quantity

43. $Each

44. Total$

45. GL

47. Description 4

49. Quantity

50. $Each

51. Total$

52. GL

54. Description 5

56. Quantity

57. $Each

58. Total$

59. GL

61. Description 6

63. Quantity

64. $Each

65. Total$

66. GL

68. After submitting this request, please submit additional documentation to Purchasing. Include all applicable invoices, receipts and shipping tickets. Reference Purchase Order number if applicable.

70. Purchasing Approval __________________________Date: ________

72. Purchase Order Number: ___________

74. PCard limit increased not to exceed 24 hours: _______

Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit

* indicates a required field