Fillable PCardOrderForm ARKANSAS TECH UNIVERSITY

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PCardOrderForm ARKANSAS TECH UNIVERSITY

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U.S.A. forms for Arkansas Tech University

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ARKANSAS TECH UNIVERSITY P-CARD ORDER FORM
(Department Name)
Russellville, AR 72801-2222 Date: _____________________
Tel: 479-___-______
Fax: 479-___-______ No. of Pages Faxed: _________
To: EDUCATIONAL SALES ORDER DEPARTMENT
Company: _______________________________________
Subject: VISA ORDER
ITEM NO.
DESCRIPTION
QUANTITY
UNIT
PRICE
EXTENDED
COST
Shipping
8.5%
Arkansas Sales Tax
TOTAL
DELIVER TO ADDRESS (Cardholder’s Name)
P-CARD ORDER
And ARKANSAS TECH UNIVERSITY
(Building & Room No.
BILL TO ADDRESS: (Street Address)
RUSSELLVILLE, AR 72801-2222
CHARGE ORDER TO: VISA CARD NO. __________________________________
EXPIRATION DATE: _________________
NAME ON CARD: _________________________________
SIGNATURE: __________________________________________________________
NOTE: ALL BACKORDERS ARE TO BE CANCELLED
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PCardOrderForm ARKANSAS TECH UNIVERSITY

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Completed 22 March 2020

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