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Request Purchase Authorization Form

This resource form is for the use of School of Nursing Faculty & Staff to request authorization of internal purchases of expenses over $50. If there are any questions, please contact your supervisor prior to use.  Thank you!

Please note

This RPO form is ONLY used for the expense authorization process. You must continue adding your requests to the SON Office Supply Request Form. Links are inclusive of a submit confirmation, and are located in the “additional resources” section on this page.

Submission Date(Required)
Current date when request is submitted.
Required for supervisory approval routing process
Employee Name(Required)
Purchase or Reimbursement(Required)
Purchase requests for items >$50 -OR- Reimbursement of items purchased against research funds, etc.
Is this expense related to:(Required)

Date needed
Identify specific time-frame / date, etc. in the “other” field.

Anticipated Expenses

Enter the item/expense description, the quantity and estimated dollar value for each anticipated expense. The TOTAL field will automatically calculate entries, please identify portion of total to be reimbursed, prepaid, etc.
Additional Items to request
Additional info, items/cost/links, validate professional development/research related activity, justification statement, etc.
Drop files here or
Accepted file types: pdf, txt, doc, jpg, png, Max. file size: 10 MB, Max. files: 10.
    Please attach all estimates or invoices with request, include product links, etc. (PDF preferred)
    Consent(Required)

    Additional Resources

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