Print Form
Department of Procurement
P-Card Administration
P-Card Request Form
Instructions:
1. Please complete all information for each card requested. (Information can be typed directly onto this form
and saved.
2. Note special circumstances or information in the space provided.
3. Print and sign the form.
4. Email completed form to [email protected].
5. Cards will be ordered twice each month. (Please see P-Card website for specific dates.)
6. A confirmation email will be sent when the card has been ordered.
*Cash Limit should be requested only in special circumstances. (Example: Cross-Cultural Courses)
First Name
Last Name
Embossed
Cardholder Name
(26 characters
maximum)
(Card Line 1)
*if different from
first/last name
Employee
ID Number
Date of
Birth
Credit
Limit
Notes:
Requested by:
Supervisor:
Date:
Single
Transaction
Limit
Cash
Limit*