B093-2409
REQUISITION FOR PURCHASE
JACKSON STATE COMMUNITY COLLEGE
2046 NORTH PARKWAY
JACKSON, TN 38301-3797
SUBMIT TO PURCHASING
VENDOR'S NAME:
ADDRESS:
P/REQ #:
VEN #:
DATE:
ACCOUNT:
OBJECT:
VENDOR CONTACT INFORMATION
PHONE:
FAX:
ITEM
NO. QUANTITY DESCRIPTION
UNIT
COST
ESTIMATED
TOTAL
Total:
JUSTIFICATION:
AUTHORIZATION
Requisitioner Dean
Department Head Vice President
President/Vice-President of Financial and Administrative Affairs