SAN DIEGO MIRAMAR COLLEGE
ASSOCIATED STUDENT BODY
CHECK REQUISITION FORM
DATE: INSTRUCTIONS:
1
ISSUE CHECK TO:
2
NAME:
E-MAIL/PHONE #:
ADDRESS:
CITY/STATE:
MAIL CHECK:
ACCOUNT NUMBER INFORMATION
CHARGE TO ACCT # :
DESCRIPTION OF ACTIVITY
(Please attach original receipt(s)/ invoice(s)
REQUESTED BY: SUB-TOTAL
DEPARTMENT #:
TAX
PHONE #:
GRAND TOTAL
APPROVAL SIGNATURES:
ASG EXECUTIVE DATE CLUB ADVISOR DATE
ASG ADVISOR DATE ACCOUNTING OFFICE DATE
Submit an approved copy of this form to the
Accounting Office along with original
receipt(s)/ invoice(s) from the vendor.
Please allow at least "5" business days for
processing.
Please make a copy of the completed form for
your records.
3
ROUTE CHECK TO:
PICK UP:
(Accounting Office)
CLUB NAME
0.00
0.00
0.00
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