campuslabs Data Driven Innovation
Campus Labs Billing Information Form
Relevant Information for Procurement/Finance
| Primary Contact Information |
| Accounts Payable Email:(Required) | accounts. payable @ Kysu. edu |
| Institution Name: | Kentucky State |
| Primary Contact: | Dr. Stashia Emanuel |
| Title: | Vice Provost Academic Affairs |
| Mailing Address: | 400 E. Main Street |
| Frankfort, KY 40601 |
| |
| |
| Phone: | 502) 597-5117 | Fax: | |
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| Email: | stashia.emanuel@kysu.edu |
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| Send Invoices to my attention: | Yes ☐ | No ☐ |
| Billing Information (if different than above) |
| Billing Contact: | |
| Title: | |
| Mailing Address: | |
| City, ST ZIP: | |
| Phone: | _____ | Fax: | |
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| Email: | |
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| Will Campus Labs be issued a PO for this requisition? | Yes ☐ | No ☐ |
| Is a Campus Labs invoice required for PO generation? | Yes ☐ | No ☐ |
| PO number is provided: | |
| Campus Labs Contact: | Tina Michalowski | |
|---|
| T: 716.270.0000 | | | 298 Main Street, Suite 6 |
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F 716.G52.2689