Chemistry Purchase Order System Form

Instructions

Fill out this form completely and print it as a PDF in landscape layout. All forms must be signed by the faculty responsible for the listed accounts. Fields marked with an * are required.  The form can be attached to an email and sent to the Business Office once the faculty signature is obtained.

Date: 
* Your Name: 
* NU NetID: 
Building/Room Number: 
Work Phone: 
Email address: 
Laboratory/Group: 

List the accounts that you would like to access. Fund, Dept. ID and Project ID must be explicitly stated for each account.

Fund

Dept. ID

Project ID

01
02
03
04
05
06
07
08
09
10

Approval

The listed individual may submit purchase requisitions to the Chemistry Business Office on the accounts designated above. I understand that it is my responsibility to notify the business office when an individual leaves my lab or is no longer authorized to spend on my accounts.

* Faculty Name: 

Signature: _______________________________________________

Date: _____/______/______

Make sure you PRINT a copy of this form for faculty signature prior to submitting.