DBES FIELD TRIP PURCHASE REQUEST

Please note: To have payment ready for the day of the field trip or
mailed prior to the event, this request must be received a minimum of
two weeks in advance.

Date: __________

Request submitted by: _____________________________

Vendor Name: __________________________________

Vendor Address: __________________________________

__________________________________

Vendor Contact: __________________________________

Vendor Phone #: __________________________________

How should the vendor be paid?

Mail check direct: _____

Take check the day of trip: _____

Total: _____

INVOICE MUST BE ATTACHED.