Department Name*
Card Administrator*
Department Address*
Department Administrator Phone*
Department Account #*
College Req #*
Up to Five authorized user names can be printed on each card. Please indicate below the number of cards requested.The combination of number of cards and user names is at your discretion. You may fill out this form a second time if addition cards are required. If you anticipate that a student may be using the card to pick-up merchandise at the merchant please indicate user name as simply "Student" followed by the card administrator's phone extension.The merchant will call you to verify the student at the point of purchase.
Card 1 - Number of Cards*
User 1*
User 2
User 3
User 4
User 5
Card 2 (Optional) - Number of Cards
User 1
User 2
User 3
User 4
User 5
As the Administrative Ram Card, card administrator, I agree to abide by URI purchasing and controller's policies and procedures. All purchases using the Administrative Ram Card will meet these guidelines.
Print- Ram Card Administrator*
Additional Information:
Note: A new application form must be completed each fiscal year. Requisitions expire on June 30th of each fiscal year.

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