Southern Utah University
SUUSA/Club Purchasing Card
Application
This application is to be submitted upon completion which includes obtaining all the required
approvals. Only one (1) club account can be attached to each Purchasing Card and a student
may only be issued one (1) card. Please see the procedures when purchasing from multiple
accounts. Also, you must be the president of the club in order to receive a purchasing card.
Cardholder Full Legal Name (Please print clearly)
Social Security # (Last Four Digits ONLY) T-Number
Phone # E-mail Address
Club Date
Name of Club or SUUSA/SPB Position ______________________________
Club/Organization Index ______________________________
Departmental Account Manager ______________________________
Department Manager E-mail ______________________________
______________________ ______________________ ______________________
SUUSA VP of Clubs SUUSA Controller’s Supervisor Approval
or SUUSA President’s Approval
Approval
For Office Use Only
Division Number __________________ Department Number ___________________
E _____ A _____ B_____ IA_____