Payment Request Form

Payment Request Form

For questions or feedback please contact the Office of Student Life.

studentlife@kellogg.northwestern.edu

Payment Request Type*

Select

Event Pre-Approval Form *

FORM - Must be Approved by Sean Winks or Jarvis Broom

(Please Upload at The Bottom of This Form)

Invoice*

(Please Upload at The Bottom of This Form)

w9 (US) or w8 (Intl)*

w9 // w8 - Must be complete with a WET signature.

(Please Upload at The Bottom of This Form)

Design Approval *

When creating commercial products using the NU/Kellogg/Club logo, you must use the registered trademark version AND purchase from a NU licensed vendor.

For design approval please reach out to both:

Sofia Park: sofia.park@kellogg.northwestern.edu

Ellen L Barnes: e-barnes@northwestern.edu

Once approved, please upload the approval email to the bottom of this form.

Excel List *

Please submit your Amazon order request in an Excel file. On the Excel list, please provide Link(s), item details (size, color, etc), item quantity, and price for each link.

**PLEASE NOTE: returns may require a processing fee and you must return items yourself**

Please use this link for student club fund reimbursements.

Treasurer Approval*

If you are NOT the Treasurer, you must upload a screenshot or email showing approval with the fund type.

Please upload Email or Slack message screenshot to the bottom of this form.

Acknowledgement *

Purchases made from unlicensed vendors WILL NOT BE paid and are ineligible for reimbursement

Club Coordinator*

Prior to purchase, please send your design to the Club Coordinator for approval ONLY if the design does not use Kellogg Trademarks or Logos.

Design Proof or Mockup

(Please Upload at The Bottom of This Form)

Please use the checklist in this form to upload the corresponding documents.*

**Note That Additional Documentation May Be Necessary Upon Request**

Drag and drop files here or

Payment For:

Your Name:

Your Kellogg Email:

Your Organization:

Select

Treasurer Email:

Vendor Name:

Vendor Email:

Vendor Phone Number:

Payment Request Amount:

FUND TYPE

Select or enter value

Payment Details

Can't Find My Organization?

Splitting Cost? (if applicable)

If splitting funds between clubs/sections, email confirmation must be obtained from EACH of the club treasurer/section leader.

Internal Notes

Comments

For any Conference Payment request please use this form link: Conference Payment Request Form

Send me a copy of my responses

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