Click to View Form Instructions New Registration or are you Amending a previous submission?:* New Registration Amendment What are you Amending (What field data are you editing)?:* i.e. Removing State Account Numbers 43008900; 43123400 and 43333300 Are you registering/amending for State, Research or Both?:* State Research Both First and Last Name:* Format: John Doe Email:* Format: JDoe@albany.edu Phone:* Format: 555 555-5555 Department:* Format: Biology Ship To Location: Building and Room:* Format: MSC 302 Street Address:* Format: 1400 Washington Ave City and Zip:* Format: Albany 12222 Add'l Ship To Location: (Only enter into these fields if you have a second location to add) Add'l Building and Room: Format: Room 200 Add'l Street Address: Format: 20 Broadway St Add'l City and Zip: Format: Schenectady 12306 Do your orders require approval?:* Yes No If Yes, You Must Enter an Approver with a corresponding Email: Approver's First and Last Name:* Approver's Email:* Accounts are required given your Registration type (State, Research, Both) State Account(s):* (Please separate by ";") Format: (8 Digits) i.e. 43008900 Research Account(s):* (Please separate by ";") Format: (13 Digits, 2 Hypens) i.e. 1234567-1-12345 OR (14 Digits, 2 Hypens) i.e. 1234567-12-12345 Online Vendor(s):* (Select at least one Vendor) (Select all that apply) Dupli Fisher Grainger Integrated DNA Tech Krackler Laboratory Products Life Technologies Office Max Proftech (Staples) S & B VWR Print a copy for your personal records prior to submission. Click "Submit" and wait until the "Thank You" confirmation page is displayed for completion. *Required Field
Approver's Email:*
Please contact us if you need assistance: purchasing@albany.edu
