Purchase Request Form

After you fill out the form, you will be contacted by Tim Kleiner and he will let you know whether the purchase has been approved or not, and when you are able to place the order.

* Indicates a required field

Name

First Name

Last Name

Email

Department

Refuge

Canaland Early Learning

Stevens Point Christian Academy

Other

Department Head/Supervisor

Date Submitted

MM

DD

YYYY

Date Needed

MM

DD

YYYY

Requested Items

Item #1 Requested

Please list the item, reason for purchase, quantity, where you are purchasing from, and cost. (Also include links for online purchases)

Item #2 Requested

Please list the item, reason for purchase, quantity, where you are purchasing from, and cost. (Also include links for online purchases)

Item #3 Requested

Please list the item, reason for purchase, quantity, where you are purchasing from, and cost. (Also include links for online purchases)

Item #4 Requested

Please list the item, reason for purchase, quantity, where you are purchasing from, and cost. (Also include links for online purchases)

Item #5 Requested

Please list the item, reason for purchase, quantity, where you are purchasing from, and cost. (Also include links for online purchases)

Total Amount (including shipping)

$