Fillable Eagle Dollars Form (Clarion University of Pennsylvania)

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Eagle Dollars Form (Clarion University of Pennsylvania)

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Eagle Dollars Departmental
Charge Application Form
Application Date:
Department:
Department Contact:
Contact Email Address:
Department Address:
Department Phone:
Budget Fund Center:
Check Attached:
Initial amount to be placed on card:
Name of Department Chair/Budget Coordinator:
Signature of Department Chair/Budget Coordinator:
Important Notes:
* Please allow 24 hours for money to be applied to account
* We are not responsible for lost funds due to lost or misplaced ID card
* We are not responsible for misuse of funds
* Department contact person will receive an email or letter confirming the charge back transactions
* Initial start amount is $25
* Contact ID Office with any questions at 393-1806
Return completed form to the ID Office, 236 Egbert Hall, Clarion University or
fax to ext. 1860
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Eagle Dollars Form (Clarion University of Pennsylvania)

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Completed 24 July 2020

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