University of Central Missouri Credit Card
Individual Corporate Account
Application
APPLICANT INFORMATION
Applicant Name
Email Address
Banner ID
Social Security
Department
FOAPAL
Campus Address
Office Liaison's
Name
City/State/Zip
Office Liaison's
Email
Position/Title
Business Phone
Cell Phone
Applicant applies to Bank of America, or its successors or assigns ("Issuer") for an account as indicated above. If this application
is accepted and credit card(s) issued, those signing below will be deemed to be in agreement with the terms and conditions
accompanying the card(s). The Applicant signing this form, certifies the information given herein to be true and correct. The
Applicant understands that the Issuer will retain the application whether or not it is approved. Because this account is offered in
conjunction with a program from your employer, certain information about you and your use of the account will be supplied to
your employer. By signing below, you consent to Issuer sharing information you provide on your application and information
about your account with your employer. Applicant agrees that unless they call Bank of America at 1-888-341-5000, Bank of
Applicant's Signature
Date
Monthly Credit Limit
Privileges Assigned
Travel Only
(Please choose one)
Purchasing Only
Authorized Approval
Both
Date
Account Number
Date of Training
Send Completed Applications to: Travel & Card Program Coordinator
Administration Building, Room 316
(Last 4) & DOB
(Budget)
(Last, First, MI)
(700#)
Warrensburg, MO 64093
Click to PRINT, sign, and date.