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Aurora University
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Supply Requisition Form

All form fields in bold blue text are required and must be filled out in order for order to be completed.

Account Number:

Department Name:

Date of Request (MM/DD/YYYY): / /

Date Supplies Needed (MM/DD/YYYY): / /

Name of Person Requesting:

Extension: (please include area code and prefix if you are off campus)

E-mail Address:

Vendor Catalog:

*Note: Supply orders over $100 total per week require a Purchase Order including the appropriate Budget Manager and Vice President signatures. A copy of the Purchase Order must be emailed or faxed to x6899 before orders over $100 will be submitted to the vendor. Please contact Valarie McClain (x7823) with any questions or for additional information.*

Qty.
UOM
Item Num
Description
List Price
Our Cost
Total Cost
1.
2.
3.
4.
5.
6.
7.
8.
9.

Note: if you need to order more items than space allows, please fill out the form a second time.

Comment: Please enter any special instructions here.

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