Purchasing PC03
University of Windsor BTA Card Application
This form is to be used by the Campus Community to apply for a UWindsor BTA Card.
Departments’ Name
(21 character limit on full name): _____________________________________________________________
Contact Individuals (First Name, Last Name): _________________________________________________________
Contact Individuals’ Business Phone Number: (519) 253- 3000 ext. ____________
Contact Individuals’ E-mail address: ______________________________@uwindsor.ca
UWinID (Used as login ID with CentreSuite): _________________________________
Significant Date: ______________________________ (month/day/year)
You must assign your own significant date. It is required by the Bank for security reasons. It must be a valid DATE (8
digits) and format must be MMDDYEAR (e.g. 12011941).
Reminder: All Cardholders must complete the mandatory online BTA Card Training and Quiz before you can pick up your BTA
Card from the Procurement Office. If the quiz is not completed when you go to pick up your BTA Card, the Purchasing Card
Administrator will not release your new card to you. Training and Quiz can be found at:
Dollar Limits ($)
Monthly Spending Limit: $ 15,000
Card Restrictions
Merchant Category Code (MCC) exclusions for this Purchasing Card will be set up as per University
defaults - refer to Cardholder Information Package.
Please list which account numbers should be linked to your purchasing card. These will be used for
transaction/expense allocation within the Scotia CentreSuite Card Management System. You must
have signing authority on these accounts:
Fund #: _________________________________________________________
Department Account# _____________________________________________
Program Account # ________________________________________________
Project Account # _________________________________________________
Classification Account # ____________________________________________
Explanation as to why the department will require a BTA Card:
Your signature below indicates approval of the form and confirms that all information is accurate. The form must be signed
with written signature or official digital signature
Contact Individual Approval Signature: _______________________________________________
Contact Approval Name (Please Print): _______________________________________________
Department Approval Signature: ____________________________________________________
Department Approval Name (Please Print): ____________________________________________
Approver Title: ____________________________ Phone Ext. ____________________________
BTA Card Agreement EMPLOYEES
(to be signed upon card issuance)
My signature indicates that I have completed the mandatory online BTA Card Training and Quiz, and that I
agree to adhere to the policies and procedures established for the program.
Cardholder Signature: ______________________________ Date: _____________________
Cardholder Name (please print): ____________________________________________________
Purchasing Services Use Only:
Date Card Was Requested: __________________________________________________________
Scotia Confirmation Number: __________________________________________________________
Date Card Received from Scotia: __________________________________________________________
Date Cardholder Completed the Online Quiz: ______________________________________________
Date Cardholder Picked up Card: __________________________________________________________
Purchasing Card Administrator Signature: ___________________________________________________
Procurement Manager Signature: _________________________________________________________
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