Office Use Only
Req #   ______________  Date   _________
P.O. #   _____________  Date   ________
_                                                                                                 _______________________ C. Smith
Kansas City, Kansas
Area Technical School
Request for Purchase
Budget Number                      140-034-800-116000                                                                               Date___________
Vendor Name & Number
_______________________________________________________________
Address                                                                                                                                                      Teacher________
City, State, Zip                                                                                                                                             Supervisor_____
Telephone and/or Fax            ________________________________________________________________________
Quantity	Catalog No.	Description	Unit Cost	Total
		Shipping
		Total
__________________________________                          ___________________________________
Please sign / date when order is received (Instructor)               Please sign / date when order is received (Receiving)