The University of Texas Health
Science Center at San Antonio / Date:
Publisher/ Vendor: / Dept Name:
Address: / Project ID:
Phone Number:
Contact:
Instructions: Departments must have estimated prices for each item. Every Requisition must be signed by the authorized person for each Project ID. Items that are requested and are not in stock will be special ordered. Typically this takes approximately 5-10 working days (may be longer in some cases). It is the department’s responsibility to follow up on existing orders.

BOOKSTORE

DEPARTMENTAL REQUISITION

Bookstore Use Only
Item # / Quantity / Description / Unit Price / Est. Total / Extended Cost / Delivery/ Pick-Up Date / Notes
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Total
Requested By: / Authorized Signature:______
Printed Name: