| 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: | |||
|---|---|---|---|---|---|
| Email: | stashia.emanuel@kysu.edu | ||||
| Send Invoices to my attention: | Yes ☐ | No ☐ | |||
| Billing Information (if different than above) | |||||
| Billing Contact: | |||||
| Title: | |||||
| Mailing Address: | |||||
| City, ST ZIP: | |||||
| Phone: | _____ | Fax: | |||
| Email: | |||||
| 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 | ||||
F 716.G52.2689