ICES Purchasing Request Form

Personal Information My Name:


My Campus Address:


My Email Address:


My Phone:
Who is your Purchasing Agent?


STUDENTS ONLY Advisor/Instructor Name:


Advisor/Instructor Email:


(* A copy of this request form will be emailed to your Advisor/Instructor.)


Oracle Account Information Oracle Account to be used for purchase:


Project Name of Oracle Account:


Account Percentage:
(Percentages should add up to 100%)
2nd Acct. (if needed) 2nd Oracle Account (if needed):

Project Name of 2nd Oracle Account:

2nd Acct Percentage:
3rd Acct. (if needed) 3rd Oracle Account (if needed):

Project Name of 3rd Oracle Account:

3rd Acct Percentage:
4th Acct. (if needed) 4th Oracle Account (if needed):

Project Name of 3rd Oracle Account:

4th Acct Percentage:


Check this box if you plan to make the purchase in person. We will supply a copy of the Purchase Order when completed.
Vendor Information Vendor Name:

Vendor Address:


Contact Name:

Contact Phone:


Item #1 Description:


SKU/Part Number:


Unit Price:


Quantity:


URL for Item #1:
Item #2 Description:


SKU/Part Number:


Unit Price:


Quantity:


URL for Item #1:
Item #3 Description:


SKU/Part Number:


Unit Price:


Quantity:


URL for Item #1:
Item #4 Description:


SKU/Part Number:


Unit Price:


Quantity:


URL for Item #1:


Shipping Information I would like the following shipping:

If you or the vendor can estimate Shipping Charges, please include them here: