E-MAIL ORDER FORM
Department
name
ContactName
name
Address
name
Phone
name
Email
name
Account #
name
Requisition # (if used)
name
Quantity
name
Item Number
name
name
name
name
name
name
name
name
name
name
name
name
name
name
name
name
name
name
name
name
Comments
Delivery Method
name
deliver to above address
pull for customer pick up
129 Dykstra phone: (785) 532-6510 fax: (785) 532-6263
storerm@ksu.edu
hours Mon. - Fri. 8:00 am - 12:00 pm and 1:00 pm - 5:00 pm
