Purchase Order Request Form

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PURCHASE ORDER REQUEST FORM
If you need a purchase order, you must submit an approved request no later than 2 days prior to the event. Please ensure
that the proper documentation is noted on the purchase order such as the fees and/or the amount of people being charged.
The following needs to be returned to Accounts Payable by 5 P.M. on the day of the event.
1. Filled out yellow copy of purchase order
2. Any receipts pertaining to the activity
3. A list of participants including adults
Requestor: ___________________
Extension (if applicable): ______________
Department
o
o
Administration
Libby Booth Elementary
o
o
th
9
Youth Center
Lois Allen Elementary
o
o
th
9
Teen Center
Nancy Gomes Elementary
o
o
Athletics
Neil Road Youth Site
o
o
Early Learning Center
Rollan Melton Elementary
o
o
Echo Loder Elementary
S.M.A.R.T. Moves
o
o
Facilities
Sun Valley Elementary
o
o
Fernley
Sun Valley Teen Center
o
o
Project Learn
Technology
o
o
Grace Warner Elementary
Track Break
o
o
Hug High Teen Center
Weed & Seed
o
o
LDJ Teen Center
Youth ArtWorks
o
o
Lemmon Valley (Summer Only)
Other: ________________________
Program (Please check all that apply)
Core Areas
Additional Program Areas
o
o
o
Career & Leadership Development
Administrative
Office Supplies
o
o
o
Education & Career
Event :__________________________
Staff Expense
o
o
o
Health & Life Skills
Field Trip
Torch Club
o
o
o
Sports, Fitness & Rec.
Food & Beverage
Training & Workshops
o
o
o
The Arts
Keystone Club
Other: ___________________
Vendor Name: __________________________________________ Charge Card Request: YES NO
Address: _____________________________________________________
Date Needed: ___________________
Time: ____________________
Amount: ___________
Approx. # of People: _____________
Reason for request: (Smart Moves, LIT, etc.) ___________________________________________
Requestor Signature: ________________
Date of Request: _____________
Supervisor Approval: ________________
PO#: ______________________
Director Approval: ______________________
Charge Card Issued: __________
CPO Approval
: __________________
Charge Card Issued: __________
(If Necessary)
(Remind Business that we are Tax Exempt – they should have a certificate on file or request
a copy of the Tax Exempt Letter to be given to the vendor.)
PURCHASE ORDER REQUEST FORM
If you need a purchase order, you must submit an approved request no later than 2 days prior to the event. Please ensure
that the proper documentation is noted on the purchase order such as the fees and/or the amount of people being charged.
The following needs to be returned to Accounts Payable by 5 P.M. on the day of the event.
1. Filled out yellow copy of purchase order
2. Any receipts pertaining to the activity
3. A list of participants including adults
Requestor: ___________________
Extension (if applicable): ______________
Department
o
o
Administration
Libby Booth Elementary
o
o
th
9
Youth Center
Lois Allen Elementary
o
o
th
9
Teen Center
Nancy Gomes Elementary
o
o
Athletics
Neil Road Youth Site
o
o
Early Learning Center
Rollan Melton Elementary
o
o
Echo Loder Elementary
S.M.A.R.T. Moves
o
o
Facilities
Sun Valley Elementary
o
o
Fernley
Sun Valley Teen Center
o
o
Project Learn
Technology
o
o
Grace Warner Elementary
Track Break
o
o
Hug High Teen Center
Weed & Seed
o
o
LDJ Teen Center
Youth ArtWorks
o
o
Lemmon Valley (Summer Only)
Other: ________________________
Program (Please check all that apply)
Core Areas
Additional Program Areas
o
o
o
Career & Leadership Development
Administrative
Office Supplies
o
o
o
Education & Career
Event :__________________________
Staff Expense
o
o
o
Health & Life Skills
Field Trip
Torch Club
o
o
o
Sports, Fitness & Rec.
Food & Beverage
Training & Workshops
o
o
o
The Arts
Keystone Club
Other: ___________________
Vendor Name: __________________________________________ Charge Card Request: YES NO
Address: _____________________________________________________
Date Needed: ___________________
Time: ____________________
Amount: ___________
Approx. # of People: _____________
Reason for request: (Smart Moves, LIT, etc.) ___________________________________________
Requestor Signature: ________________
Date of Request: _____________
Supervisor Approval: ________________
PO#: ______________________
Director Approval: ______________________
Charge Card Issued: __________
CPO Approval
: __________________
Charge Card Issued: __________
(If Necessary)
(Remind Business that we are Tax Exempt – they should have a certificate on file or request
a copy of the Tax Exempt Letter to be given to the vendor.)

Download Purchase Order Request Form

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