UNIVERSITY LIBRARIES

Library Business Services

Request For Supplies or Special Orders

DEPARTMENT:                                           REQUEST DATE: 

Contact Person:                                            Text Box: All Special Orders Must Have Approval of Dept. Chair and Budget Officer.Telephone: 

                                              Dept. Chair:______________________  Budget Officer:________________________

Item Description:    

Stock Number:

Number of Units Ordered:  

Unit Price: 

Total Order Amount:

 SUPPLIER: 

 Street Address:       

 City:                                       State:                              Zip Code: 

Telephone:                                               FAX:  

 E-Mail:

                                                           JUSTIFICATION