UCSD Recreation Outback Adventures Recharge Form

Instructions: Completely fill out this form for each recharge. A recharge is the process for one
UCSD Department to be charged for goods and services provided by another UCSD Department.

Upon completion, your information will be emailed to Outback Adventures staff for review and you will receive an email confirmation. You will receive another email notification at a later date when the recharge information is submitted to Accounting for processing.

Items with an * are required fields.

Purchase and Recharge/Project-Task Information

Which Outback Adventures program area should this recharge be paid to? This program area will receive an email notification that the form was completed. *

Please choose the date of your program (if multiday, please choose the first day) * +

Please provide a short description of the services/goods purchased with this recharge?

-Challenge Course/Group Adventures/Climbing Center/WO: Enter Group name and date/s of program
-Surf Shop/Rental Shop: enter a short general description of items purchased/rented *

Total amount (or estimate) to be charged? *

Do you want to split the charge over multiple Project-Task combinations? *

Project Number (xxxxxxx)? *

Task Number (xx)

$ to be charged to this Project-Task? *

Project Number (xxxxxxx)? *

Task Number (xx)

$ to be charged to this Project-Task? *

Project Number (xxxxxxx)?

Task Number (xx)

$ to be charged to this Project-Task?

Purchasing Department Information

Contact name *

Contact Phone Number *

Mail code

Title *

Department Name *

Email address (a copy of completed recharge form will be sent to this email address) *

Any additional comments?

Signature *

clear