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 Course/Capstone/eProject/FURI Purchase Request
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Name of Class or Project: EGR 304/314Vendor (one vendor per form): Amazon
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DateFaculty/PI ContactStudent Name & EmaileProject? Capstone Project? Course Project?eProject Industry Sponsor (if applicable)
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3/7/26Kevin NicholsKevin Shah kshah79@asu.edu Yes / No Yes / No Yes / Non/a
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A purchasing card is available to check out for local purchases or you may come to Sutton 101 and order your supplies, using this purchasing card.
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QtyItem # or Quote #Direct Website Link to ProductGeneral Description of ItemBusiness Purpose/Benefit for the PurchaseUnit PriceLine Total
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612345ABCDEwww.thisistheplace.com/12345ABCDE (SAMPLE: PLEASE START ON NEXT LINE)safety gogglesprotect student/instructor eyes while working
on project; benefit to the University of reducing number of accidents in the lab		 $ 3.490 $ 20.94
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4DIANN B0BNQD38T2
Amazon.com: DIANN 3.2" ILI9341 SPI TFT LCD Display Touch Panel 320x240 TFT LCD Touch Screen Shield 5V/3.3V STM32 Display Module SPI Serial with Touch Pen : Industrial & Scientific
Used to display the stuff from the Sensors LED $ 13.99 $ 55.96
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Sub-Total $ 55.96
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 Chair or PI Approval: Date: Tax
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Shipping
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Grand Total $ 55.96
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Business Purpose/Public Benefit: (Click on yellow line. Next, select an option on the drop-down arrow on the right of the box)
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Lab / Classroom / Medical Supplies
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Business Purpose: A commodity needed for experimentation, observation or practice in a field of study (such as goggles, aprons, test tubes, flasks, and plates etc).
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Public Benefit: Supplies are used in day-to-day lab operations. ASU benefits from this expense as the supplies purchased allow departmental lab employees and students to perform general lab duties, projects, and research activities.
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Student: Forward completed form to Instructor/Project Mentor for approval
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Mentor/Faculty: Forward form with email indicating your approval to PolyBizz@asu.edu for processing
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1. A purchasing card is available to check out for local purchases. 2. You may come to Sutton 101 and place your order online.
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SECTION BELOW IS FOR OFFICE USE ONLY
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ORDER PLACED BY / DATE:B.O. NOTIFIED BY / DATE:
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ORDER RECEIVED BY / DATE:STUDENT / INSTRUCTOR NOTIFIED BY / DATE:
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COST CENTER + PROGRAM/GIFT TO CHARGE:
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