Student Prize Form
Event Information:
Name of Program or Event: ____________________________________ Date: __________________
Desired Goals/Outcomes: _____________________________________________________________
___________________________________________________________________________________
Program/Event Coordinator: ___________________________________________________________
Award/Prize Information:
Item Description: _________________________________ Cost: ________________________
Serial # (if applicable): ______________________________________________________________
OASIS Transaction ID: __________________________________________ (attach copy of receipt)
Date of Purchase: ______________________________________________________________
Recipient’s Information:
Name: _________________________________________________ F#__________________________
Address: ____________________________________________________________________________
___________________________________________________________________________________
Phone: _____________________________________________________________________________
Signatures:
Program/Event Coordinator_________________________________________ Date ________________
Recipient ________________________________________________________ Date ________________
PCard Coordinator ________________________________________________ Date _________________
This form must be completed to document the purchase and distribution of any student prizes.
Send the original signed form to Procurement for PCard Coordinator Signature.
A signed copy will be returned to the event representative and must be scanned with the PCard Receipt.
Revised May 1, 2016
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