| Form Field |
Description |
| Department |
Department that submits the request. The department name should be identical to the
department name on the Merchant Account Application Form. |
| Technical Contact |
Primary contact person in the department for technical issues. |
| Phone |
University telephone number where the technical contact can be reached. |
| Mail List Address: |
Mail list where information regarding technical issues will be sent.
(example: XXXX_epay_support@usask.ca, where XXXX=Department) |
| Merchant Application Support - Employee Name |
Name of the Merchant Application Support person(s) who will be authorized to access the ITS
Pay Page & Moneris Test Server |
| Merchant Application Support - NSID |
NSID of the Merchant Application Support person(s) who will be
authorized to access the ITS Pay Page & Moneris Test Server |
| Authorized Signature: |
Signature of the person in the department authorized for technical issues. |
| Date: |
Date form completed and forwarded to Treasury Office. |
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