Procurement Card Application

Your Information

First Name*

Last Name*

Email Address*

CSU ID Number*

CSU eID*

Department*

The department you are employed by:

Supervisor Name*

Cardholder Verification Information

The below information will be used by JP Morgan Chase to verify your identify if/when you need to contact them.

Date of Birth*

Mother's Maiden Name or Password*

10 character maximum. This will be used to verify your identity (not for login credentials).

Cell Phone*

Phone

Justification

Business Need Justification*

Provide detail about anticipated purchases to include frequency, estimate dollar amounts, vendors, etc. Insight about why other purchase methods are not suitable (shop catalogs, vendor reimbursement, purchase order, etc.)

Do your duties include buying goods and supplies for official function events?*

(e.g. small purchases at grocery stores, department stores, etc.)

Select

Do your duties include planning and scheduling official function events?*

(e.g. restaurants, catering, hotel conference room charges)

Select

Send me a copy of my responses