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									                      PURCHASING CARD APPLICATION PROCESS.

Before a University Purchasing card can be ordered, the intended Card Holder needs to complete the form on the
following page.

Steps Required:

    1. Print and complete the National Australia Bank Application Form.
       Only complete fields marked with a     (Required fields will also be shaded light yellow on screen).

    2. Sign the National Australia Bank form in two (2) places where indicated.
       Seek approval signature from delegated officer (Band 4 or Higher).

    3. Send completed form to Card Services:

        Scan and email to:             OR

        Fax to: Card Services – 02 49215152        OR

        Internal Mail: Card Services, 1st Floor, The Chancellery,

        You will be contacted once the application has been received.
        The card will ordered and usually takes 5 working days to arrive.
        Card Services will be in touch once the card has been delivered to the University.

        Please bring along some photo Identification with you (Drivers Licence or Passport will suffice).

By Signing the application form you are declaring you have read the University's Purchasing Card policy
and agree to the below conditions of use.

I agree to use the University Purchasing Card in accordance with the following conditions:-

1. I will read the purchasing card policy found at
2. I will use the Purchasing Card solely to purchase goods and services for official University use and in
 accordance with the approved Policy and Procedures for use of Purchasing Cards.
3. I will ensure that the Purchasing Card will be kept in a safe place when not in use.
4. I understand that action may be taken against me of the amounts recovered if I misuse the card.
5. I will advise the Bank and the University immediately if the card is lost or stolen.
6. I will return the card to the University in the event of my resignation or termination of employment.
7. I will abide by the "Conditions of Use" issued by the Bank which apply to the University Visa Purchasing Card.
                                            National Australia Bank Limited
                                            ABN 12 004 044 937                                                              Visa Purchasing -
                                                                                                                            Cardholder Request

 Customer Details
 Company ID           Account       Company/Business Name                                     Customer Number (CIS#)                 Billing Account
 9133                 4715 27       THE UNIVERSITY OF NEWCASTLE                               797310344                              4715 2798 0000 0505
 Cardholder Details
 Surname (NM2L)                                    Given Name (NM2 F)                          Mid Initial (NM2 M)          Title (Mr / Ms etc) (NM2 S)

                                               *                                              *                         *                                  *
 System Administrators Name (ADR1)                   System Administrators Address (ADR2)                    City           State    Postcode (ADR 3)
 Attn: Brent Matthews                                   Procurement – The Chancellery                              CALLAGHAN NSW 2308
 Type Appr       Own BSB            Dom BSB                Credit Limit                    PIN (Y/N)         Staff Number                  Uni Id
    Y                 082748          086992
                                                                                         *    N                                      *                    *
 Job Title                                                                                                 Email

                                                                                                       *                                                  *
 Faculty / Division                                                           Phone                               Fax

                                                                      *                                *
 Cardholder Consent
 I, the person named above as Cardholder consent to the issue of a card of the card type selected above (“Card”) in my name for my use as
 Agent of the Customer named herein. I acknowledge that use of the Card issued will be governed by Conditions of Use which will
 accompany the Card (as the same may be amended from time to time) and by which I agree to be bound.
 Cardholder Signature (1 of 2)                                                         Date

School/Division Authorised officer - I authorise the issue of a “Corporate Card” to the person named above.
 signature                                         Name (Print)                                                                     Date

Faculty PVC/Division Head - I authorise the issue of a “Corporate Card” to the staff member named above.
 PVC / Division Head signature                     Name (Print)                                                                     Date

                                          *                                                                                  *
 Customer Authority
 The Customer hereby requests issue of a Card to the abovementioned Cardholder in terms of and pursuant to the Customer’s National
 Australia Bank Limited Card Facility Offer Letter and Terms and Conditions (“Card Facility”). The Cardholder’s signature is verified and
 Cardholder Request approved with the above credit limit.
 Signed for and on behalf of the Customer
 Authorised Signature/s                                                                                    Date

 Certificate of Identity under Regulation 5 Financial Transaction Reports Act 1998 (“FTR Act”)
 I declare that I am an authorised Verifying Officer for the Customer referred to above in relation to the Card Facility. In accordance with the
 FTR Act I certify that the Cardholder whose details are completed above is authorised by the above Customer to be a signatory to the Card
 Verifying Officer’s Signature                      Date                              Verifying Officers
                                                                                      Public Authorities and Incorporated Bodies as defined under
                                                                                      the FTR Act (these include incorporated associations and
 Cardholder Signature (2 of 2)                      Date                              proprietary companies that have traded for a continuous
                                            *                                         of two years, or maintained an account with a financial
                                                                                      institution for a continuous period of two years) may nominate
 Cardholder Acknowledgment (on receipt of Card & conditions of use)                   a Verifying Officer under the FTR Act.
 I hereby acknowledge receipt of my:
    Card and copy of “Conditions of Use”                                              Business Banker use
    PIN                                                                                 Request signed in terms of customer authority held
    Copy of “Conditions of Use for Electronic Banking” (if PIN issued)                  AUSTRAC ID held (if Certificate of Identity not
 Cardholder’s signature:                                 Date:
                                                                                      Manager/Business Banker signature and Outlet stamp
 Cards Use Only
 Card Type 1          1IS    ASN    Suffix (Plastic Type) Create Plastic
   V             1              9         77                      Y

 Input by - Initials:       Date:                  Card Number:           4    7 1 5      2 7

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