Marketplace Request Form

不良研究所 Faculty and Staff with event registration requests that also include the collection of payments must submit a separate Marketplace Store Front Request Form.

The 不良研究所 Business Office oversees the creation of online payment transactions and will contact you after receiving your submission. Pease allow up to seven business days for your account setup.

Please don't fill out this input box.

Requestor Name*Please provide the first and last name of the person making the request.

Requestor Email*Please provide your email address

Requestor Department or Office*Please provide the name of the requestor's department or office

Supervisor Name*Please provide the first and last name of the requestor's supervisor.

Cost Center*Please provide your cost center number

Event Date and Time*Please provide the date and time of the event for which you are collecting funds

Cost*Please provide the amount you are charging for your event. (If more than one amount is available, please include a category name)

Event Description*Please provide a description of the event. This content will be placed on the registration page for visitors. Please be as descriptive as possible.)

Space Limitations*Please provide the number of registrations/pieces available for purchase. If space is limited please include the total number of items available.

Form Data Fields*Please include a full list of registrant information you would like collected. (Name, address, phone, email, etc.)

Go Live Date*Please select the date and time you would like your marketplace store to be live and able to collect payments