America To Go Order Form

Vendor or Restaurant

Amount (Estimated Within $100)

FDM String

Section I: Sponsoring Entity

Sponsoring Entity

ODOS

VPSA

Cultural Programming Board (CPB)

ODE

Student Council

Multicultural Student Services (MSS)

Other

Other

Section II: Delivery Information

Delivery Contact Name

Delivery Contact Phone#

Event/Program/Committee Title

Event Date

Approximate Attendance

Delivery Location (Address)

Event/Program Location (if different from Delivery Location)

Delivery Time

Section III: Order Information

Provide the Item, Quantity and Description

Person Spending Money

Email

Supervisor/Advisor/Designee

Email

Second Supervisor/Advisor/Designee

If applicable

Email

I certify that this expenditure has been made in accordance with policies and within the parameters of our budget.

Submit

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