CAT$cratch DEPOSIT SLIP

Name of Cardholder_________________________________________
                                    Last                                                         First

UVM ID Number________________________________
( UVM assigned number)

Amount (minimum $20)   $___________

Name on check or charge card
_______________________________Phone__________

MC/Visa/Disc/Amex #
_______________________________Exp__________

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For Office Use Only
Date_______  Cash____ CK #__________ Initials_______

CATcard Service Center
Dudley H. Davis Center, 590 Main Street
Burlington, VT 05405-0152

802-656-4509     Fax 802-656-4528

Last modified April 18 2011 12:25 PM