Central Receiving Request for Pick up
Date
From
Department
Vendor
Vendor Address
Original Purchase Order #
Description of item to be returned
Quantity returned
Price
Description of item to be returned
Quantity returned
Price
Description of item to be returned
Quantity returned
Price
Reason For Return
Reason for Return - Other
FORT LEWIS COLLEGE      1000 RIM DRIVE DURANGO, COLORADO 81301      (877)FLC-COLO(TOLL FREE)      ADMISSION@FORTLEWIS.EDU