Cabrillo College
Purchase Requisition for Student Senate and Cabrillo Clubs ONLY
Please print clearly in blue or black ink, no staples, please paperclip all documentation to Purchase Requisition
Date:____________ Date of Minutes:____________
Vendor:_______________________________________
Club Name or Senate:________________________
Address:______________________________________
Requested By:______________________________
_____________________________________________
Phone Ext: circle one: 3508 or 3584 or 6525
Tax ID or SS or SID#_____________________________
Deliver to:_________________________________
Vendor No._____________________________________
Budget Number:
Total Expense: $
Budget Name:
Quantity
Unit
Catalog No.
PO Attn To:
Description of items or service (include style, color, etc.)
Unit Price
Amount
Payment Delivery:  mail check to address above  hold check at BSO, Bldg. 2600
Documentation check-off:
 Meeting Minutes
Always required
 Scholarship or transfer?
Need only minutes
 Re-imbursement?
Need original receipts
 Ordering goods or services?
Need quote from vendor
 Paying a bill?
 District Credit Card?
Need original invoice
SIGNATURE(S) REQUIRED: I hereby acknowledge this expense was approved by the above named organization;
valid minutes and documentation are attached.
APPROVED
President or Treasurer
Date:
APPROVED
For Clubs: Advisor
Date:
Subtotal:
Sales Tax:
Shipping:
For office use only:
APPROVED
Student Activities Coordinator
Date:
APPROVED
Dean of Student Services
Date:
 Docs complete
White: BSO
D:\612865979.doc
Date sent to BSO:
PO#
Yellow: Student Affairs
Total:
PV#
Amount
Pink: Organization
rev. ADF, 7/09