REQUISITION
Letterhead, Envelopes, Memo Pads, and Folders
All information must be filled out in order to process order. Please do not write in shaded areas.
Department/Office:
BILLING
CONTACT
Type of Account:
Account #:
Ordered By: Authorized Signature: Date:
Date to Printer: Job #: Email Address:
Name: Phone:
ORDER
(Please use separate order
form for each item)
STYLE
(Check appropriate box. All
University and Medicine
materials will be printed red
and black or black only. All
others will be as specified.)
Stony Brook University
Stony Brook Medicine
Stony Brook Medicine University Physicians
Children’s Hospital
Other (Specify which card or provide sample and colors)
(Note: Don’t forget to keep a
copy for your records)
DELIVERY
Building/Level/Room:
No. of Boxes: Received By: Date Received:
ADDITIONAL
INFORMATION
(Attach separate sheet if
more room is needed)
(In case we have a question)
Other RF State
SBF CPMP
Fax: Email Address:
No Yes
Sample Attached:
If “No”, provide information on “Additional Information” below
Envelopes
No Yes
Sample Attached:
Quantity:
If “No”, provide information on “Additional Information” below
Type:
#10 Standard
#10 Window #9 Remittance
500 Minimum
Dept:
SB PO
Contents: Quantity:
Address:
Req# Box of
Fantastic Graphics, Inc., 101 Verdi Street, Farmingdale, NY 11735 (631) 753-4144
Dept:
SB PO
Contents: Quantity:
Address:
Req# Box of
Fantastic Graphics, Inc., 101 Verdi Street, Farmingdale, NY 11735 (631) 753-4144
DO NOT FILL OUT BELOW
Letterhead
Quantity:
500 minimum
Size: 8.5 x 11
Mohawk 100% recycled
Mohawk 100% recycled
If “No”, provide information on “Additional Information” below
Memo Pads
No Yes
Sample Attached:
Quantity:
10 Pad minimum
Size:
4.25 x 5.5
5.5 x 8.5
Mohawk 100% recycled
PLACE YOUR
ORDER
By Email:
sborders@pugsprint.com
Please aach sample .pdf
or word document
By Fax:
631- 753- 3753
Please send sample with fax
By Mail:
Fantasc Graphics, Inc., 101
Verdi St., Farmingdale, NY 11735
Have Quesons?
Call us at
631- 753- 4144
Folders
Quantity:
100 minimum
Size:
Standard
9 x 12
Expandable
9 x 12
Stony Brook University
Stony Brook Medicine
Red and Black Black
Color:
Children’s Hospital
SUSB8000 (11/12)
www.stonybrook.edu/procurement
No: (AUTOMATICALLY ASSIGNED AFTER PRINTING)
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