Supplies
Request Form
(PLEASE PRINT)
Requested by: __________________________________________________
Date Requested: ________________________________________
Date Needed By*: ________________________________________
Name of Supplier to
be used: ______________________________
Item(s) Needed:
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Item Description |
Catalog Number* |
Qty. |
Price |
Grant(s) To be Charged and allocation |
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Approved By: ______________________________
Project Coordinator**
1. Please note that supply orders are typically placed during pay weeks. Your completed request form should be submitted to the fiscal coordinator no later than the friday before pay weeks, to ensure that sufficient funds are available.
2. Project Coordinators are responsible for verifying that sufficient funds are available in the project’s budget.
______________________________________________________________________________
FOR FISCAL USE ONLY:
Date reimbursed
__________ Check #
________________
Executive Director/Associate Director ____________________________ Date_____________