(CENTRAL PAYMENT SCHOOLS ONLY)
Original Applicant Information
Title – Mr/Mrs/Miss/Ms/Other / First Name: / Surname:
Employee Number:
PCard number (last 4 digits only)
Personal detail changes - only complete required fields
Name changes are required to be supported by supporting documentation e.g. marriage certificate
New title – Mr/Mrs/Miss/Ms/Other / New first Name: / New surname:
School:
New postal address of work base:
Town:
Postcode:
New work telephone number:
New work email address:
New home address:
Town:
Postcode:
Budget Information – additional codes
If more cost centres are required than can be listed below please complete details on a separate sheet and attach to application
Approval must be obtained from each Budget Holder responsible for every cost centre listed below
I am the budget holder for the costcentres as indicated below
I authorize a purchase card to be issued to the applicant named above with the financial limits detailed below -Director for Finance and Procurement approval will be sought where these limits exceed standard values
I agree to maintain oversight of purchase card spend using budget holder reports, requesting more information if required
I have read and understood the purchase card policy document & user guide. I agree to comply with their requirements
Where the card is in the name of the Headteacher, the Head of Governors will need to sign the form
Where the card is in the name of a school employee, the Headteacher will need to sign the form
Cost centre / Budget Holder Name / Budget Holder Signature
Removal of Cost centres* Cost centres to be removed from your Fraedom account
Cost Centre / Date to be removed
Financial limits
*Where expenditure limits are requested above the standard, approval from Director forFinance and Procurementall relevant budget holdersis required
Monthly expenditure limit(standard £3,000):
Single transaction limit(standard £2,000):
End date (if increase is to be on a temporary basis):
Please state full details of why higher limits are being requested:
Financial limits approval*To be completed by Director for Finance and Procurement
I agree / do not agree to the named applicant having increased financial limits as stated above applied to their card (delete as appropriate)
Signature - Director for Finance and Procurement: / Date:
cardholder declaration
I confirm that the amendments to my personal details, as indicated above, are correct at the date shown below
Signature of Cardholder: / Date:
Amendments to cost centres and financial limits should be emailedby the Headteacher or Head of Governors.Each individual application needs to be scanned in pdf format and emailed as individual attachments to:
Amendments to personal details should be emailedby the cardholder.Each individual application needs to be scanned in pdf format and emailed as individual attachmentsto: