Technology Connection - Payment Information

Completing payment
(or refund) for a : *

First Name *

Last Name *

Billing Address Line 1

Billing Address Line 2

City

State

Zip Code

Billing Phone Number

Email Address

Technology Connection Quote # 🛈

Please enter the Technology Connection Quote # you would like to pay

Purchase Amount $
(if refund, please enter amount of the refund)

We will contact you if your order exceeds the amount you approve here.

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

CVV Code *

Tulane Billing Information

Tulane Billing AND Shipping Information

Check here to CONFIRM Billing, Shipping Address, or Pick Up Options *

YES, Billing and Shipping are the SAME

NO, Billing and Shipping are DIFFERENT

Departmental Orders MUST ship to Tulane Facilities

SHIPPING?

First Name

Last Name

Bill To and Ship To Department

Bill To and Ship To Address Line 1

Bill To and Ship To Address Line 2

City

State

Zip Code

Bill To and Ship To Phone Number

Bill To and Ship To Email Address

First Name

Last Name

Billing Department

Billing Address Line 1

Billing Address Line 2

City

State

Zip Code

Billing Phone Number

Billing Email Address

Tulane Shipping Information

Ship To First Name

Ship To Last Name

Ship To Department

Shipping To Address Line 1

Shipping To Address Line 2

Ship To City

Ship To State

Ship To Zip Code

Shipping Contact Phone Number

Shipping Contact Email Address

Name of person picking up this order @ Technology Connection *

(a Tulane Photo ID will be required)

Ship To First Name

Ship To Last Name

Shipping To Address Line 1

Shipping To Address Line 2

Ship To City

Ship To State

Ship To Zip Code

Shipping Contact Phone Number

Shipping Contact Email Address *

Technology Connection Quote # 🛈

Please enter the Technology Connection Quote # you would like to pay

Purchase Amount $$$$

We will contact you if your order exceeds the amount you approve here.

Payments over $500 - IT Preferred - Payments over $1499 - EIT Required
(Subject to change)

Payment Method *

The above form may be used for all credit card payments or refunds.

Note to Tulane Departments wishing to pay by EIT:
(This is not for students)
Instructions are listed here:
https://techconnect.tulane.edu/sites/default/files/TC_new_EIT_procedures_22.pdf

Name on Tulane PCard *

Email for Tulane PCard *

Tulane PCard Number *

PCard Expiration Date (mm/yy) *

CVV Code *

PCard Billing Zip Code *