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<title>THE UNIVERSITY OF NEW MEXICO</title>
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<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:9.0pt'>THE <st1:place w:st=3D"on"><st1:Pla=
ceType
 w:st=3D"on">UNIVERSITY</st1:PlaceType> OF <st1:PlaceName w:st=3D"on">NEW M=
EXICO</st1:PlaceName></st1:place><o:p></o:p></span></b></p>

<h3><span style=3D'font-size:9.0pt;font-family:"Times New Roman"'>STUDENT
GOVERNMENT ACCOUNTING OFFICE<o:p></o:p></span></h3>

<h3><st1:place w:st=3D"on"><st1:PlaceName w:st=3D"on"><span style=3D'font-s=
ize:9.0pt;
  font-family:"Times New Roman"'>STUDENT</span></st1:PlaceName><span
 style=3D'font-size:9.0pt;font-family:"Times New Roman"'> <st1:PlaceName w:=
st=3D"on">UNION</st1:PlaceName>
 <st1:PlaceType w:st=3D"on">BUILDING</st1:PlaceType></span></st1:place><span
style=3D'font-size:9.0pt;font-family:"Times New Roman"'> 1018<span
style=3D'mso-spacerun:yes'>&nbsp; </span></span><span style=3D'font-size:9.=
0pt;
font-family:Symbol;mso-ascii-font-family:"Times New Roman";mso-hansi-font-f=
amily:
"Times New Roman";mso-char-type:symbol;mso-symbol-font-family:Symbol'><span
style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>&middot;</span=
></span><span
style=3D'font-size:9.0pt;font-family:"Times New Roman"'> MSC 03 2210<span
style=3D'mso-spacerun:yes'>&nbsp; </span></span><span style=3D'font-size:9.=
0pt;
font-family:Symbol;mso-ascii-font-family:"Times New Roman";mso-hansi-font-f=
amily:
"Times New Roman";mso-char-type:symbol;mso-symbol-font-family:Symbol'><span
style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>&middot;</span=
></span><span
style=3D'font-size:9.0pt;font-family:"Times New Roman"'> (505) 277-7888 </s=
pan><span
style=3D'font-size:9.0pt;font-family:Symbol;mso-ascii-font-family:"Times Ne=
w Roman";
mso-hansi-font-family:"Times New Roman";mso-char-type:symbol;mso-symbol-fon=
t-family:
Symbol'><span style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>=
&middot;</span></span><span
style=3D'font-size:9.0pt;font-family:"Times New Roman"'> Fax:<span
style=3D'mso-spacerun:yes'>&nbsp; </span>(505) 277-2987<o:p></o:p></span></=
h3>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:9.0pt'>Email: <a href=3D"mailto:sgao@unm.e=
du"><span
style=3D'font-weight:normal'>sgao@unm.edu</span></a> </span></b><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:9.0pt;font-f=
amily:
Symbol;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:"Times=
 New Roman";
mso-char-type:symbol;mso-symbol-font-family:Symbol'><span style=3D'mso-char=
-type:
symbol;mso-symbol-font-family:Symbol'>&middot;</span></span></b><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:9.0pt'> webs=
ite <span
class=3DSpellE>www.unm.edu/~sgao</span> </span></b><span style=3D'font-size=
:9.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
style=3D'font-size:9.0pt'><o:p>&nbsp;</o:p></span></p>

<h1><span style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>INTERNAL
REQUISITION<o:p></o:p></span></h1>

<p class=3DMsoNormal><span style=3D'font-size:8.0pt;font-family:"Bookman Ol=
d Style"'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'><span
style=3D'font-family:"Bookman Old Style"'>Organization:</span></b><span
style=3D'font-family:"Bookman Old Style"'><span style=3D'mso-spacerun:yes'>=
&nbsp;
</span><u><span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span></u></span><u=
><span
style=3D'font-size:16.0pt;font-family:"Bradley Hand ITC"'>Zoology Club<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></u><b style=3D'mso-bidi-font-weight:normal'><span
style=3D'font-family:"Bookman Old Style"'>Date:</span></b><span style=3D'fo=
nt-family:
"Bookman Old Style"'><span style=3D'mso-spacerun:yes'>&nbsp; </span><u><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
</span></u></span><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'>10/4/06</span></u=
><u><span
style=3D'font-family:"Bookman Old Style"'><span style=3D'mso-tab-count:2'>&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span><span style=3D'color:white'>=
.</span></span></u><span
style=3D'font-family:"Bookman Old Style"'><o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-family:"Bookman Old Style"'><o:p>&=
nbsp;</o:p></span></p>

<p class=3DMsoNormal><b><span style=3D'font-family:"Bookman Old Style"'>Org=
anization
Contact</span></b><span style=3D'font-family:"Bookman Old Style"'>:<span
style=3D'mso-spacerun:yes'>&nbsp; </span><u><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span></u></span><u><sp=
an
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'>Tom Garcia<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp; </span></span></u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span><b><span style=3D'font-famil=
y:"Bookman Old Style"'>Phone</span></b><span
style=3D'font-family:"Bookman Old Style"'>: <u><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span></u></span><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'>867-5309<span
style=3D'mso-spacerun:yes'>&nbsp; </span></span></u><span style=3D'font-fam=
ily:
"Bookman Old Style"'><span style=3D'mso-spacerun:yes'>&nbsp;</span><b>E-mail
address</b>: <u><span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span></u></s=
pan><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'>TommyG@unm.edu</s=
pan></u><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:14.0pt;font-=
family:
"Bradley Hand ITC"'><o:p></o:p></span></b></p>

<div style=3D'mso-element:para-border-div;border:solid windowtext 3.0pt;
padding:3.0pt 0in 0in 4.0pt'>

<p class=3DMsoNormal style=3D'tab-stops:202.5pt;border:none;mso-border-alt:=
solid windowtext 3.0pt;
padding:0in;mso-padding-alt:3.0pt 0in 0in 4.0pt'><b><span style=3D'font-siz=
e:
9.0pt'>TYPE OF REQUEST <span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span>=
<i
style=3D'mso-bidi-font-style:normal'>(Check one below)</i></span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></=
b><i
style=3D'mso-bidi-font-style:normal'><span style=3D'font-size:7.0pt;mso-bid=
i-font-weight:
bold'>Estimated Business Days: Petty Cash =3D <span class=3DGramE>Same</spa=
n> day, <span
class=3DSpellE>SPO&#8217;s</span>/PR&#8217;s =3D 2-3 days, Checks/PO&#8217;=
s =3D
10-14 days, Transfers =3D 3-5 days<o:p></o:p></span></i></p>

</div>

<p class=3DMsoNormal style=3D'line-height:150%;tab-stops:.75in 85.5pt 211.5=
pt 405.0pt'><b><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp; </span></b><b><span
style=3D'font-size:9.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
1)<span
style=3D'mso-spacerun:yes'>&nbsp; </span><span class=3DGramE>Reimbursement =
:</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>2)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Payment:<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp; </span>3)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Other:<o:p></o:p></span></b></p>

<p class=3DMsoNormal style=3D'line-height:150%;tab-stops:.75in 1.0in 85.5pt=
 225.0pt 423.0pt'><b><span
style=3D'font-size:9.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp; </span></span></b><b><span
style=3D'font-size:8.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
___<span
class=3DGramE>_<span style=3D'mso-spacerun:yes'>&nbsp; </span>Check</span><=
span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =
</span>____<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Off-Campus Vendor<span style=3D'ms=
o-tab-count:
1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp; </span>____<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Award/Honorarium</span></b><b><span
style=3D'font-size:9.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
<o:p></o:p></span></b></p>

<p class=3DMsoNormal style=3D'line-height:150%;tab-stops:.75in 1.0in 85.5pt=
 225.0pt 423.0pt'><b><span
style=3D'font-size:9.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp; </span></span></b><b><span
style=3D'font-size:8.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
___<span
class=3DGramE>_<span style=3D'mso-spacerun:yes'>&nbsp; </span>Petty</span> =
Cash </span></b><span
style=3D'font-size:8.0pt;line-height:150%;font-family:"Bookman Old Style";
mso-bidi-font-weight:bold'>(under $100)<b> <span style=3D'mso-tab-count:1'>=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>____<span
style=3D'mso-spacerun:yes'>&nbsp; </span>On-Campus Vendor </b>(one time pay=
ment)<b><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>____<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Funds Transfer</b></span><b><span
style=3D'font-size:9.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
<o:p></o:p></span></b></p>

<p class=3DMsoNormal style=3D'text-indent:.5in;line-height:150%;tab-stops:8=
5.5pt 225.0pt 238.5pt 247.5pt 445.5pt'><b><span
style=3D'font-size:8.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp; </span><u><span
style=3D'mso-spacerun:yes'>&nbsp;</span></u></span></b><b><u><span
style=3D'font-size:14.0pt;line-height:150%;font-family:"Bradley Hand ITC"'>=
X </span></u></b><b><span
style=3D'font-size:8.0pt;line-height:150%;font-family:"Bookman Old Style"'>=
<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span>On-Campus Master Setup</span>=
</b><b><span
style=3D'font-size:8.0pt;line-height:150%'><o:p></o:p></span></b></p>

<div style=3D'mso-element:para-border-div;border:solid windowtext 3.0pt;
padding:3.0pt 0in .25in 4.0pt'>

<p class=3DMsoNormal style=3D'tab-stops:202.5pt;border:none;mso-border-alt:=
solid windowtext 3.0pt;
padding:0in;mso-padding-alt:3.0pt 0in .25in 4.0pt'><b><span style=3D'font-s=
ize:
9.0pt'>SPECIAL HANDLING REQUESTS<span style=3D'mso-spacerun:yes'>&nbsp;&nbs=
p;
</span><i style=3D'mso-bidi-font-style:normal'>(If necessary)</i><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></b><=
/p>

<p class=3DMsoNormal style=3D'tab-stops:202.5pt;border:none;mso-border-alt:=
solid windowtext 3.0pt;
padding:0in;mso-padding-alt:3.0pt 0in .25in 4.0pt'><b><span style=3D'font-s=
ize:
1.0pt'><o:p>&nbsp;</o:p></span></b></p>

</div>

<p class=3DMsoNormal style=3D'tab-stops:405.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b
style=3D'mso-bidi-font-weight:normal'><span
style=3D'mso-spacerun:yes'>&nbsp;</span></b><b style=3D'mso-bidi-font-weigh=
t:normal'><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt;font-family:"Bookman Old=
 Style"'><o:p></o:p></span></b></p>

<div style=3D'mso-element:para-border-div;border:solid windowtext 3.0pt;
padding:2.0pt 0in 0in 4.0pt'>

<h5 style=3D'border:none;mso-border-alt:solid windowtext 3.0pt;padding:0in;
mso-padding-alt:2.0pt 0in 0in 4.0pt'><span style=3D'font-size:9.0pt'>PAYEE
INFORMATION <span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span><i
style=3D'mso-bidi-font-style:normal'>(Check one)</i><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span><span style=3D'font-size:10.=
0pt;
font-family:"Bookman Old Style"'>____ Student<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span>____ Faculty/Staff<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp; </span>____ Foreign Nat=
ional<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp; </span></span><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";font-weight:normal;
mso-bidi-font-weight:bold'><span style=3D'mso-spacerun:yes'>&nbsp;</span><s=
pan
style=3D'mso-spacerun:yes'>&nbsp;</span></span></u><u><span style=3D'font-s=
ize:
16.0pt;font-family:"Bradley Hand ITC";mso-bidi-font-weight:bold'>X</span></=
u><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";font-weight:normal;
mso-bidi-font-weight:bold'><span style=3D'mso-spacerun:yes'>&nbsp; </span><=
/span></u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";font-weight:normal;
mso-bidi-font-weight:bold'><span style=3D'mso-spacerun:yes'>&nbsp;</span></=
span><span
style=3D'font-size:10.0pt;font-family:"Bookman Old Style"'>Other</span><span
style=3D'font-size:9.0pt'><o:p></o:p></span></h5>

</div>

<h2><o:p>&nbsp;</o:p></h2>

<h2 style=3D'line-height:10.0pt;mso-line-height-rule:exactly'><!--[if gte v=
ml 1]><v:shapetype
 id=3D"_x0000_t202" coordsize=3D"21600,21600" o:spt=3D"202" path=3D"m,l,216=
00r21600,l21600,xe">
 <v:stroke joinstyle=3D"miter"/>
 <v:path gradientshapeok=3D"t" o:connecttype=3D"rect"/>
</v:shapetype><v:shape id=3D"_x0000_s1031" type=3D"#_x0000_t202" style=3D'p=
osition:absolute;
 margin-left:-6.75pt;margin-top:9.1pt;width:567pt;height:1in;z-index:1'
 strokeweight=3D"1.5pt"/><![endif]--><![if !vml]><span style=3D'mso-ignore:=
vglayout;
position:absolute;z-index:1;margin-left:-10px;margin-top:11px;width:762px;
height:103px'>

<table cellpadding=3D0 cellspacing=3D0>
 <tr>
  <td width=3D762 height=3D103 bgcolor=3Dwhite style=3D'border:1.5pt solid =
black;
  vertical-align:top;background:white'><![endif]><![if !mso]><span
  style=3D'position:absolute;mso-ignore:vglayout;z-index:1'>
  <table cellpadding=3D0 cellspacing=3D0 width=3D"100%">
   <tr>
    <td><![endif]>
    <div v:shape=3D"_x0000_s1031" style=3D'padding:5.1pt 8.7pt 5.1pt 8.7pt'
    class=3Dshape>
    <p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Eras =
Light ITC";
    mso-bidi-font-family:Arial'>This sample can be used for setting up <b
    style=3D'mso-bidi-font-weight:normal'>MASTER ACCOUNTS</b> to on-campus
    vendors, including:<o:p></o:p></span></p>
    <p class=3DMsoNormal style=3D'margin-left:.75in;text-indent:.5in'><span
    style=3D'font-size:11.0pt;font-family:"Eras Light ITC";mso-bidi-font-fa=
mily:
    Arial'>-<span style=3D'mso-spacerun:yes'>&nbsp; </span>The Daily Lobo<s=
pan
    style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
    style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp; </span><span
    class=3DGramE>-<span style=3D'mso-spacerun:yes'>&nbsp; </span>Digital</=
span>
    Printing<o:p></o:p></span></p>
    <p class=3DMsoNormal style=3D'margin-left:1.0in;text-indent:.25in'><span
    style=3D'font-size:11.0pt;font-family:"Eras Light ITC";mso-bidi-font-fa=
mily:
    Arial'>-<span style=3D'mso-spacerun:yes'>&nbsp; </span>ITS<span
    style=3D'mso-tab-count:5'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp; </span><span
    class=3DGramE>-<span style=3D'mso-spacerun:yes'>&nbsp; </span><st1:plac=
e w:st=3D"on"><st1:PlaceName
     w:st=3D"on">Student</st1:PlaceName> <st1:PlaceName w:st=3D"on">Union</=
st1:PlaceName>
     <st1:PlaceType w:st=3D"on">Building</st1:PlaceType></st1:place><o:p></=
o:p></span></span></p>
    <p class=3DMsoNormal style=3D'margin-left:1.0in;text-indent:.25in'><span
    style=3D'font-size:11.0pt;font-family:"Eras Light ITC";mso-bidi-font-fa=
mily:
    Arial'>-<span style=3D'mso-spacerun:yes'>&nbsp; </span>Physical Plant
    Department<o:p></o:p></span></p>
    <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><i
    style=3D'mso-bidi-font-style:normal'><span style=3D'font-size:11.0pt;
    font-family:"Eras Light ITC";mso-bidi-font-family:Arial'>No address is
    necessary for on-campus vendors.</span></i><i style=3D'mso-bidi-font-st=
yle:
    normal'><span style=3D'font-size:11.0pt;font-family:"Eras Light ITC"'><=
o:p></o:p></span></i></p>
    </div>
    <![if !mso]></td>
   </tr>
  </table>
  </span><![endif]><![if !mso & !vml]>&nbsp;<![endif]><![if !vml]></td>
 </tr>
</table>

</span><![endif]><span style=3D'font-weight:normal'>Payment to Individual/V=
endor:
</span><u><span style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";
font-weight:normal'><span style=3D'mso-spacerun:yes'>&nbsp;</span>Daily Lob=
o<span
style=3D'mso-spacerun:yes'>&nbsp; </span></span></u><span style=3D'font-wei=
ght:
normal'><span style=3D'mso-spacerun:yes'>&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span><span style=3D'ms=
o-tab-count:
1'>&nbsp; </span>Social Security #<span style=3D'mso-spacerun:yes'>&nbsp; <=
/span></span><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";font-weight:normal=
'><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:1'>&nb=
sp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp; </span><span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span><=
/u><span
style=3D'font-weight:normal'><o:p></o:p></span></h2>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'font-si=
ze:8.0pt;
mso-bidi-font-size:10.0pt;font-family:"Bookman Old Style"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span=
><span
style=3D'mso-spacerun:yes'>&nbsp;</span>(Individual)<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;
</span><o:p></o:p></span></p>

<h2 style=3D'line-height:10.0pt;mso-line-height-rule:exactly'><span
style=3D'font-weight:normal'>Address:</span> <span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span><u><span style=3D'font-size:1=
4.0pt;
font-family:"Bradley Hand ITC";font-weight:normal'><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:1'>&nb=
sp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:4'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:1'>&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></span></u><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span><span style=3D'fo=
nt-weight:
normal'>UNM ID #10 </span><span style=3D'mso-bidi-font-size:8.0pt;font-weig=
ht:
normal'>__ __ __ __ __ __ __ </span><span style=3D'font-size:8.0pt;font-wei=
ght:
normal'>(</span><span style=3D'font-size:8.0pt;font-family:"Times New Roman=
";
font-weight:normal'>Student/Employee</span><span style=3D'font-size:8.0pt;
font-weight:normal'>)</span><span style=3D'font-weight:normal'><o:p></o:p><=
/span></h2>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt;font-family:"Bookman Old=
 Style"'><span
style=3D'mso-spacerun:yes'>&nbsp;</span><o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt;font-family:"Bookman Old=
 Style"'><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span><span style=3D'font-size:8.0=
pt;
mso-bidi-font-size:10.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;
</span></span><u><span style=3D'font-size:14.0pt;font-family:"Bradley Hand =
ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span><span style=3D'mso-tab-=
count:
1'> </span><span style=3D'mso-tab-count:5'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span><span style=3D'mso-tab-=
count:
1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></u><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp; </span></span><span
style=3D'font-family:"Bookman Old Style"'>Federal Tax ID #</span> ______<b
style=3D'mso-bidi-font-weight:normal'>______________<span class=3DGramE>_<s=
pan
style=3D'font-size:8.0pt;font-family:"Bookman Old Style";font-weight:normal=
'>(</span></span></b><span
style=3D'font-size:8.0pt'>Vendor</span><span style=3D'font-size:8.0pt;font-=
family:
"Bookman Old Style"'>)</span><span style=3D'font-size:8.0pt;mso-bidi-font-s=
ize:
10.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:8.0pt;mso-bi=
di-font-size:
10.0pt'><span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></b><span style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'=
>City<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span>St=
ate<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>Zip<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><span style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt;
font-family:"Bookman Old Style"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span=
><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><o:p></o=
:p></span></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'><span style=3D'mso-tab-=
count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><s=
pan
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:1'>&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><span
style=3D'font-family:"Bookman Old Style"'>Payee</span><span style=3D'font-s=
ize:
8.0pt;mso-bidi-font-size:10.0pt;font-family:"Bookman Old Style"'> </span><s=
pan
style=3D'font-family:"Bookman Old Style"'>Contact</span><span style=3D'font=
-size:
8.0pt;mso-bidi-font-size:10.0pt'>:<span style=3D'mso-spacerun:yes'>&nbsp; <=
/span></span><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span=
><span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp; </span><span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span></u><span style=3D'font-size=
:8.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-spacerun:yes'>&nbsp;</span></=
span><span
style=3D'font-family:"Bookman Old Style"'>Phone</span><span style=3D'font-s=
ize:
8.0pt;mso-bidi-font-size:10.0pt'>:<span style=3D'mso-spacerun:yes'>&nbsp; <=
/span></span><u><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span><span style=3D'ms=
o-tab-count:
2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
 </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span></span></u><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;</span>E-</span><span style=3D'font-family=
:"Bookman Old Style"'>mail</span><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'> </span><span
style=3D'font-family:"Bookman Old Style"'>address</span><span style=3D'font=
-size:
8.0pt;mso-bidi-font-size:10.0pt'>: </span><u><span style=3D'font-size:14.0p=
t;
font-family:"Bradley Hand ITC"'><span style=3D'mso-tab-count:4'>&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></u><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:8.0pt;mso-bidi-font-size:10.0=
pt'><o:p>&nbsp;</o:p></span></p>

<div style=3D'mso-element:para-border-div;border:solid windowtext 3.0pt;
padding:2.0pt 0in 1.0pt 0in'>

<p class=3DMsoNormal style=3D'border:none;mso-border-alt:solid windowtext 3=
.0pt;
padding:0in;mso-padding-alt:2.0pt 0in 1.0pt 0in'><b style=3D'mso-bidi-font-=
weight:
normal'><span style=3D'font-size:9.0pt'>DESCRIPTION OF ITEMS TO BE PURCHASE=
D <i
style=3D'mso-bidi-font-style:normal'>(Attach additional page (s) if more sp=
ace is
needed)</i><o:p></o:p></span></b></p>

</div>

<p class=3DMsoNormal><span style=3D'font-size:8.0pt;mso-bidi-font-size:10.0=
pt'>Quantity<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>Unit<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>Item Description<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'mso-spacerun:yes'>&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span>Unit Price<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>Total<o:p></o:p></span></p>

<table class=3DMsoNormalTable border=3D1 cellspacing=3D0 cellpadding=3D0 wi=
dth=3D756
 style=3D'width:567.0pt;margin-left:.9pt;border-collapse:collapse;border:no=
ne;
 mso-border-alt:solid windowtext .5pt;mso-padding-alt:0in 5.4pt 0in 5.4pt;
 mso-border-insideh:.5pt solid windowtext;mso-border-insidev:.5pt solid win=
dowtext'>
 <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;height:13.35pt'>
  <td width=3D60 valign=3Dtop style=3D'width:45.0pt;border:solid windowtext=
 1.0pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
3.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:.5in;border:solid windowtext 1=
.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D480 valign=3Dtop style=3D'width:5.0in;border:solid windowtext=
 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><span style=3D'font-size:14.0pt;font-family:"Bradley=
 Hand ITC"'>Daily
  Lobo Ads <o:p></o:p></span></p>
  </td>
  <td width=3D66 valign=3Dtop style=3D'width:49.5pt;border:solid windowtext=
 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D102 valign=3Dtop style=3D'width:76.5pt;border:solid windowtex=
t 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><span style=3D'font-size:14.0pt;font-family:"Bradley=
 Hand ITC"'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;height:16.95pt'>
  <td width=3D60 valign=3Dtop style=3D'width:45.0pt;border:solid windowtext=
 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt;height:16.95pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:.5in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
6.95pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D480 valign=3Dtop style=3D'width:5.0in;border-top:none;border-=
left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
6.95pt'>
  <p class=3DMsoNormal><span style=3D'font-size:14.0pt;font-family:"Bradley=
 Hand ITC"'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=3D66 valign=3Dtop style=3D'width:49.5pt;border-top:none;border-=
left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
6.95pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D102 valign=3Dtop style=3D'width:76.5pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
6.95pt'>
  <p class=3DMsoNormal><span style=3D'font-size:14.0pt;font-family:"Bradley=
 Hand ITC"'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;height:13.35pt'>
  <td width=3D60 valign=3Dtop style=3D'width:45.0pt;border:solid windowtext=
 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:.5in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
3.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D480 valign=3Dtop style=3D'width:5.0in;border:none;border-righ=
t:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;
  height:13.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D66 valign=3Dtop style=3D'width:49.5pt;border:none;border-righ=
t:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;
  height:13.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D102 valign=3Dbottom style=3D'width:76.5pt;border:none;border-=
right:
  solid windowtext 1.0pt;mso-border-top-alt:solid windowtext .5pt;mso-borde=
r-left-alt:
  solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;mso-border=
-left-alt:
  solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;padding:
  0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Bradley=
 Hand ITC"'>Not
  to exceed</span><span style=3D'font-size:11.0pt'><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes;
  height:13.35pt'>
  <td width=3D60 valign=3Dtop style=3D'width:45.0pt;border:solid windowtext=
 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:.5in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:1=
3.35pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D480 valign=3Dtop style=3D'width:5.0in;border:solid windowtext=
 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><span
  style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;
  </span><b style=3D'mso-bidi-font-weight:normal'>TOTAL REQUEST<o:p></o:p><=
/b></p>
  </td>
  <td width=3D66 valign=3Dtop style=3D'width:49.5pt;border:solid windowtext=
 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>$<o:p></o:p=
></b></p>
  </td>
  <td width=3D102 valign=3Dtop style=3D'width:76.5pt;border:solid windowtex=
t 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;background:#DFDFDF;mso-shading:white;mso-pattern:gr=
ay-125 auto;
  padding:0in 5.4pt 0in 5.4pt;height:13.35pt'>
  <p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>$<span
  style=3D'mso-spacerun:yes'>&nbsp; </span></b><span style=3D'font-size:14.=
0pt;
  font-family:"Bradley Hand ITC"'>300.00<b style=3D'mso-bidi-font-weight:no=
rmal'><o:p></o:p></b></span></p>
  </td>
 </tr>
</table>

<div style=3D'mso-element:para-border-div;border:solid windowtext 3.0pt;
padding:1.0pt 0in 1.0pt 0in'>

<p class=3DMsoCaption style=3D'border:none;mso-border-alt:solid windowtext =
3.0pt;
padding:0in;mso-padding-alt:1.0pt 0in 1.0pt 0in'><span style=3D'font-size:9=
.0pt'>ACCOUNT
NUMBERS TO CHARGE AND <span class=3DGramE>AMOUNTS<span
style=3D'mso-spacerun:yes'>&nbsp; </span><i style=3D'mso-bidi-font-style:no=
rmal'>(</i></span><i
style=3D'mso-bidi-font-style:normal'>Fill-in all that apply)</i><o:p></o:p>=
</span></p>

</div>

<p class=3DMsoNormal style=3D'margin-right:-12.6pt;line-height:10.0pt;mso-l=
ine-height-rule:
exactly'>ACCOUNT: 670-<u><span style=3D'font-size:14.0pt;font-family:"Bradl=
ey Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>000<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span></span></u><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span>&shy;- <u><span style=3D'font=
-size:
14.0pt;font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span>69Y0<span
style=3D'mso-spacerun:yes'>&nbsp; </span></span></u><span
style=3D'mso-spacerun:yes'>&nbsp;</span>$ <u><span style=3D'font-size:14.0p=
t;
font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span>300.00<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span></span></u><span style=3D'fo=
nt-size:
14.0pt;font-family:"Bradley Hand ITC"'><span style=3D'mso-tab-count:7'>&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
</span></span><span
style=3D'font-family:"Bradley Hand ITC"'>not to exceed<o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'>ACCOUNT:
670-<u><span style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span></span></u><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span>&shy;- <u><span style=3D'font=
-size:
14.0pt;font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span><span style=3D'mso-tab-=
count:
1'>&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span=
><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span></span></u><span
style=3D'mso-spacerun:yes'>&nbsp;</span>$ <u><span style=3D'font-size:14.0p=
t;
font-family:"Bradley Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span></span></u><span
style=3D'mso-tab-count:1'> </span><span style=3D'mso-spacerun:yes'>&nbsp;</=
span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b
style=3D'mso-bidi-font-weight:normal'>TOTAL CHARGE AMOUNT</b><b style=3D'ms=
o-bidi-font-weight:
normal'><span style=3D'font-family:Symbol;mso-ascii-font-family:"Times New =
Roman";
mso-hansi-font-family:"Times New Roman";mso-char-type:symbol;mso-symbol-fon=
t-family:
Symbol'><span style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>=
&reg;<span
style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>&reg;<span
style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>&reg;<span
style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>&reg;<span
style=3D'mso-char-type:symbol;mso-symbol-font-family:Symbol'>&reg;</span></=
span></span></span></span></span>
</b><b style=3D'mso-bidi-font-weight:normal'><span style=3D'font-family:Sym=
bol;
mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:"Times New Ro=
man";
mso-char-type:symbol;mso-symbol-font-family:Symbol'><span style=3D'mso-char=
-type:
symbol;mso-symbol-font-family:Symbol'>&reg;<span style=3D'mso-char-type:sym=
bol;
mso-symbol-font-family:Symbol'>&reg;</span></span></span><span class=3DGram=
E><span
style=3D'background:silver;mso-highlight:silver;mso-shading:white;mso-patte=
rn:
gray-10 auto'>$ <span style=3D'mso-spacerun:yes'>&nbsp;</span></span><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";background:silver;
mso-highlight:silver;font-weight:normal'>300.00</span></span></b><span
style=3D'font-size:14.0pt;font-family:"Bradley Hand ITC";background:silver;
mso-highlight:silver'><span style=3D'mso-tab-count:1'>&nbsp; </span><o:p></=
o:p></span></p>

<p class=3DMsoNormal style=3D'margin-right:.9pt;line-height:10.0pt;mso-line=
-height-rule:
exactly'><span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p; </span><b><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Account #<=
span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Acco=
unt-code<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;
</span><span style=3D'mso-spacerun:yes'>&nbsp;</span>Amounts</span></b><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:8.0pt;mso-bi=
di-font-size:
10.0pt'>(Should match total request)<o:p></o:p></span></b></p>

<p class=3DMsoNormal style=3D'margin-right:.9pt;line-height:10.0pt;mso-line=
-height-rule:
exactly'><b style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:=
8.0pt;
mso-bidi-font-size:10.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=3DMsoBodyTextIndent style=3D'margin-left:0in;text-align:justify;
text-indent:0in;line-height:10.0pt;mso-line-height-rule:exactly'><span
style=3D'font-family:"Times New Roman";font-weight:normal;mso-bidi-font-wei=
ght:
bold;font-style:normal;mso-bidi-font-style:italic'>Location of Event</span>=
<span
style=3D'font-family:"Times New Roman";font-weight:normal;mso-bidi-font-wei=
ght:
bold'>: </span><u><span style=3D'font-size:14.0pt;font-family:"Bradley Hand=
 ITC";
font-weight:normal;mso-bidi-font-weight:bold;font-style:normal'><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:2'>&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span></u><span style=3D'font-fami=
ly:"Times New Roman";
font-weight:normal;mso-bidi-font-weight:bold'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span></span><span style=3D'font-fa=
mily:
"Times New Roman";font-weight:normal;mso-bidi-font-weight:bold;font-style:n=
ormal;
mso-bidi-font-style:italic'>Date of Event: </span><u><span style=3D'font-si=
ze:
14.0pt;font-family:"Bradley Hand ITC";font-weight:normal;mso-bidi-font-weig=
ht:
bold;font-style:normal;mso-bidi-font-style:italic'><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:2'>&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </spa=
n><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span></u><span style=3D'font-fami=
ly:"Times New Roman";
font-weight:normal;mso-bidi-font-weight:bold;font-style:normal;mso-bidi-fon=
t-style:
italic'><span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span># of Attendees<span
style=3D'mso-spacerun:yes'>&nbsp; </span></span><u><span style=3D'font-size=
:14.0pt;
font-family:"Bradley Hand ITC";font-weight:normal;mso-bidi-font-weight:bold;
font-style:normal;mso-bidi-font-style:italic'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;</span></span></u><span
style=3D'mso-tab-count:4'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span style=3D'mso-tab-count:5'>&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;</span><span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'font-size:8.0pt;font-family:"Times New Roman";letter-spacing:-.4pt;
font-weight:normal'>For purchases involving Food items (A list is required =
for
less than 21 attendees)</span><span style=3D'font-weight:normal'><o:p></o:p=
></span></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>Detailed Reason for Purchase:<span
style=3D'mso-spacerun:yes'>&nbsp; </span><u><span style=3D'font-size:14.0pt;
font-family:"Bradley Hand ITC"'>Ads to notify surrounding campus of Zoology
club meetings and<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'color:white'>.</span><o:p></o:p></span></u></p>

<p class=3DMsoNormal><u><span style=3D'font-size:14.0pt;font-family:"Bradle=
y Hand ITC"'><span
style=3D'mso-spacerun:yes'>&nbsp;</span><span class=3DGramE>speaker</span> =
events.<span
style=3D'mso-tab-count:5'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:6'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span=
><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'color:white'>.</span></span></u></p>

<p class=3DMsoNormal><i style=3D'mso-bidi-font-style:normal'><span
style=3D'font-family:Baskerville'><o:p>&nbsp;</o:p></span></i></p>

<p class=3DMsoNormal><i style=3D'mso-bidi-font-style:normal'><span
style=3D'font-family:Baskerville'><o:p>&nbsp;</o:p></span></i></p>

<p class=3DMsoNormal>__________________________________________________<span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp; </span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>__________________________=
__________________________</p>

<p class=3DMsoNormal><b><span style=3D'font-size:9.0pt;mso-bidi-font-size:1=
0.0pt'>Authorized
Signature</span></b><span style=3D'font-size:9.0pt;mso-bidi-font-size:10.0p=
t'><span
style=3D'mso-tab-count:4'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span=
>Date<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp; </span><b>Authorized
Signature</b><span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;
</span>Date</span></p>

<h4 style=3D'line-height:10.0pt;mso-line-height-rule:exactly'><b
style=3D'mso-bidi-font-weight:normal'>Note:<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>Payee cannot authorize his or her own reimbursement<o:p></o:p></b></=
h4>

<div style=3D'mso-element:para-border-div;border:solid windowtext 3.0pt;
padding:1.0pt 4.0pt 1.0pt 4.0pt'>

<h5 style=3D'line-height:10.0pt;mso-line-height-rule:exactly;border:none;
mso-border-alt:solid windowtext 3.0pt;padding:0in;mso-padding-alt:1.0pt 4.0=
pt 1.0pt 4.0pt'><span
style=3D'font-size:9.0pt'>SGAO Office Use Only <span style=3D'mso-tab-count=
:4'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span><o:p></o:p></span></h5>

</div>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'>Comments:
<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:6'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </s=
pan><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'font-size:9.0pt;mso-bidi-font-size:10.0pt'>Approved <span class=3D=
GramE>by<span
style=3D'mso-spacerun:yes'>&nbsp; </span>_</span>_______&shy;&shy;_<b
style=3D'mso-bidi-font-weight:normal'><span style=3D'mso-spacerun:yes'>&nbs=
p;&nbsp;
</span></b>Date<span style=3D'mso-spacerun:yes'>&nbsp; </span>__________<o:=
p></o:p></span></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><span
style=3D'font-size:9.0pt;mso-bidi-font-size:10.0pt'><o:p>&nbsp;</o:p></span=
></p>

<p class=3DMsoNormal style=3D'line-height:10.0pt;mso-line-height-rule:exact=
ly'><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:9.0pt;mso-bi=
di-font-size:
10.0pt'><span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;</span></span></b><span style=3D'font-size=
:9.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span=
><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'mso-tab-count:4'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-spacerun:yes'>&nbsp;</span>Document<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>__________<span class=3DGram=
E>_<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Tracking</span> # ______<o:p></o:p=
></span></p>

<div style=3D'mso-element:para-border-div;border:none;border-bottom:solid w=
indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .5pt;padding:0in 0in 1.0pt 0in;
margin-left:.5in;margin-right:0in'>

<p class=3DMsoNormal style=3D'text-indent:.5in;line-height:10.0pt;mso-line-=
height-rule:
exactly;border:none;mso-border-bottom-alt:solid windowtext .5pt;padding:0in;
mso-padding-alt:0in 0in 1.0pt 0in'><b style=3D'mso-bidi-font-weight:normal'=
><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'>White &#8211; SGAO<span
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>Yellow &#8211; Student Organization <span style=3D'mso-tab-count:1'>=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;</span></span></b><span
style=3D'font-size:8.0pt;mso-bidi-font-size:10.0pt'>Revised 2/07<o:p></o:p>=
</span></p>

</div>

</div>

</body>

</html>
