Name of eMarket *

Department *

Does the department have an existing web-site? *

• Yes
• No

If yes to the above, what is the address/URL?

Requestor *

Requestor Phone Number *

Alternative Requestor Name

Alternative Phone Number

Purpose of the eMarket *

Is this eMarket for a one-time event or an on-going purpose *

• One-time
• On-going

eMarket Start Date *

Preferred format: mm/dd/yyyy

eMarket End Date

Preferred format: mm/dd/yyyy

E-mail Address for Successful Transaction *

This must be a Xavier e-mail address.

Are the goods/services for this eMarket taxable? *

• No
• Yes

Will physical goods be shipped? *

• No
• Yes

Fund Number

Contact the Accounting Office at extension 4840 for information regarding the FOAP string.

Organization Number

Contact the Accounting Office at extension 4840 for information regarding the FOAP string.

Account Number

Contact the Accounting Office at extension 4840 for information regarding the FOAP string.

Program Number

Contact the Accounting Office at extension 4840 for information regarding the FOAP string.

If deferred account is requested, what is the FOAP where the revenue should be recognized?