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Purchase Request Form
Submit one (1) form for each item/service requested. Please allow a minimum of 10 business days for approval and processing. Applicable receipts, invoices, and such must be received in office physically, via email or fax for your request to be submitted to Finance for processing.
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Name of Requestor
Your answer
Contact Number
Your answer
Email Address
Your answer
Name of Ministry
Your answer
Ministry Leader (if different from Requestor)
Your answer
Service / Item
Your answer
Description / Purpose
Your answer
Unit Price
Your answer
Shipping & Handling Cost
Your answer
Taxes & Any Other Applicable Fees
Your answer
Discount/Coupon Amount or Coupon Code (if available)
Your answer
Rewards Number (if available)
Your answer
TOTAL COST
Your answer
Check Request
Complete this section if you are needing a check for your purchase.
Make Check Payable To
Your answer
Check Is To Be
Choose
Picked Up
Hand Delivered
Placed In Ministry Box
Mailed (provide address below)
Check Handling Details
i.e. mailing address, person picking up and when, etc.
Your answer
Credit Card Request
Complete this section if your purchase requires a credit card.
Web Address for Purchase
Your answer
Account Login Information (if applicable)
Your answer
Need By Date
MM
/
DD
/
YYYY
Time
:
AM
PM
Check all that apply
Invoice Available
Reimbursement Needed
Receipt Available
Credit Ministry Budget
Church Check
Other:
Are there more requests to follow this one?
Choose
Yes
No
Submit
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