CBSM Purchase Request Form - Student Organizations
Please follow the Purchasing Policy and Procedures for CBSM Student Support Fund Accounts for all purchases requested via this form. Contact Jillian Bjornstad at jbjornstad@alaska.edu or (907) 474-5611 if you need a copy of this document.
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Name of Student Organization *
Contact Name *
Contact Phone Number *
Contact Email Address *
Contact Student ID Number *
Event Information
If this purchase is for a specific event, please enter ALL relevant information below. If this is not for a specific event, please enter the general purpose for the request under "Event Name" and proceed to the rest of the form.
Event Name *
Event Description or Purpose
Event Date
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YYYY
Event Location
Event Attendees or Audience
Is this a recurring event?
Clear selection
Purchase Information
Purchases can be made by checking out a ProCard (University credit card) from Jillian Bjornstad in Bunnell 201.

NOTE: If this is an online purchase, it is preferable for Jillian to make the purchase for you. In this case, please email Jillian a link and all necessary purchase details at jbjornstad@alaska.edu in addition to completing this form.
What type of purchase are you making? *
What do you plan to purchase? *
Please provide as much detail as possible
Will the amount of your purchase be greater than $150? *
If so, Jillian Bjornstad (jbjornstad@alaska.edu) must receive an email from your faculty advisor indicating approval for this purchase.
Required
Will this purchase be used as an award, gift, or door prize? *
When would you like to check out the ProCard? *
Please provide at least 24 hours notice before checking out a card
MM
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DD
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YYYY
Time
:
When do you plan to return the ProCard? *
ProCards must be returned within 24 hours unless approved by Jillian Bjornstad.
MM
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DD
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YYYY
Time
:
Is there any additional information we need to know about your purchase?
I understand that I will be personally financially responsible for any expenses or purchases beyond what is detailed in this form. *
Please check this box to agree with this statement.
Required
I understand that the procard and an original itemized receipt must be returned to Jillian Bjornstad or the CBSM Dean's Office within 24 hours after checking it out. *
Please check this box to agree with this statement.
Required
Submit
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