This vendor type is:
Employee
Student
Other
Make this vendor active in Grizmart?
Yes
No
This vendor:
Is New
Requires an Information Change
Requires Address Change
Note: All vendor type "Other" require a W-9 and copy of the vendor invoice to be sent to Business Services/Vendor Request.
This vendor is:
Travel, Reimbursement, or Refund
Providing a Product
Stipend/Participant Support Cost/ or Human Subject
Contract Service/Guest Speaker
Business Enterprise Designation:
Minority
Female
Disadvantaged
Not Applicable
Note: Do not mark this section if vendor is a Person.
Businesses Only
.
Vendor Name:
Banner ID/SSN/TIN:
Address:
Phone:
City:
State:
Zip:
FAX:
Note: Employees/Students must list home address; Students may also use department address, but
Dorm Addresses cannot be used
.
Additional instructional comments or questions are welcome:
Requested By:
Phone:
Dept:
Email:
