Student Organization Payment Request Form Page 3

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COMPLETE THE FOLLOWING FOR ALL REQUESTS 
 
Today’s Date ____________     Date Needed ___________    Date of Event ______________  
Student Org._________________________________________________________________  
Student Contact: _____________________________________________________________ 
Phone: _______________________                       Email: ______________________________ 
Specific event or activity for payment request:______________________________________  
Did Senate approve to pay for this event? _________________________________________ 
If yes, how much was approved by Senate? ________________________________________ 
 
Advisor’s signature ___________________________________________________________ 
 
**EVERY INDIVIDUAL/ORGANIZATION BEING PAID MUST HAVE A RECENT W‐9 ON FILE** 
**REIMBURSEMENTS MUST INCLUDE ORIGINAL, ITEMIZED RECEIPTS** 
BLANK W‐9’s are available through the Office of Student Life & via email 
 
 

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