UW-Green Bay Account Set-up or Revision Request Form I'm Trying To: (Select All That Apply)* Add a new MD account Add or update an address Add an authorized user to the Pre-Posting Allocation Tool (PAT) Inactivate an MD account Re-activate an MD account Remove an additional address Remove someone from the Pre-Posting Allocation Tool (PAT) Reset a Password Update a primary account holder Update a financial contact Update a funding string Update an existing department name Will you be the Primary Account Holder?*YesNoYour Contact InformationThis information will be used for questions about the request and any possible edits during the approval process.Your Name*Your Phone Number*Your Email* Add New/ Re-Activate MD AccountYour Employee ID*This can be found on your earning statement. If you are unable to locate your employee ID please contact Shop@UW Customer Service.MD Number You Would Like to Re-activate*Department Name*Primary Account Holder Information Primary Account Holder Name*Primary Account Holder Employee ID*They can find this on their earning statement. If you are unable to locate the employee ID please contact Shop@UW Customer Service.Primary Account Holder Phone*Primary Account Holder Email* Primary Account Holder Address Information Building Name/Room Number*Delivery Address* Address Line Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Financial Contact Information For example the ADA, Financial Specialist, Dean’s Assistant, etc. in your Department/Division. If the primary contact is also the financial contact, please enter primary contact information.Financial Contact Name*Financial Contact Phone*Financial Contact Email* Building Name/Room Number*Financial Contact Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code University of Wisconsin Shared Financial System Funding (SFS) Fund*Program*Department ID*Account*Unit*Project Grant (If Any)Funding Start DateOptional Date Format: MM slash DD slash YYYY Funding End DateOptional Date Format: MM slash DD slash YYYY Update an Existing AccountMD Number*Update an Existing AccountYour Employee ID*This can be found on your earning statement. If you are unable to locate your employee ID please contact Shop@UW Customer Service.MD Number*Department Name*Primary Account Holder Information Primary Account Holder Name*Primary Account Holder Employee ID*They can find this on their earning statement. If you are unable to locate the employee ID please contact Shop@UW Customer Service.Primary Account Holder Phone*Primary Account Holder Email* Building Name/Room Number*Delivery Address* Room Number Address Line City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Add or Update an AddressWhat would you like to do?*Update Primary Account Holder AddressUpdate an Existing Additional AddressAdd a New Additional Address If you are intending to update the primary contact name or contact information on this account, please select "Update a primary account holder" from the list at the top of the form instead Address IDThis can be found in the drop-down located in your Shipping InfoShipping Contact Name*Shipping Contact Email Shipping Contact PhoneBuilding Name/Room Number*Delivery Address* Address Line Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Remove an AddressShipping Contact Name*Building Name/ Room Number*Delivery Address* Address Line Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Financial Contact InformationFor example the ADA, Financial Specialist, Dean’s Assistant, etc. in your Department/Division. If the primary contact is also the financial contact, please enter primary contact information.Financial Contact Name*Financial Contact Phone*Financial Contact Email* Building Name/ Room Number*Financial Contact Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code University of Wisconsin Shared Financial System Funding (SFS)Fund*Program*Department ID*Account*Unit*Project Grant (If Any)Funding Start DateOptional Date Format: MM slash DD slash YYYY Funding End DateOptional Date Format: MM slash DD slash YYYY Add an Authorized User To The Pre-Posting Allocation ToolPAT Contact Name* First Last PAT Contact Phone*PAT Contact Email* Is this user replacing someone who no longer needs PAT access? Yes Remove Someone from the Pre-Posting Allocation ToolPAT Contact Name To Remove* First Last PAT Contact Email To Remove* Inactivate an MD NumberMD Number You Would Like to Inactivate*Reset Your PasswordOnly primary account contacts can request password resets Once the primary account holder has been updated, the password will be reset and the temporary password will be sent to the contact information above. Reset Your PasswordOnly primary account contacts can request password resets Once the account is activated, a temporary password will be sent to the primary account holder. Reset Your PasswordOnly primary account contacts can request password resets Once the account is reactivated, a temporary password will be sent to the primary account holder. ATTENTION A mandatory online training course is required for Primary Contacts on ALL New Account Requests, Account Reactivation and Primary Account Holder Updates. You will need your Employee ID to complete this training. Click here to access the course. Notes for Approvers or Shop@UWContacts for ApprovalEnter the name and contact information of your direct supervisor. Once you click submit an email will go to your direct supervisor and then to your purchasing department for approval Manager Name*This could be your direct supervisorManager Phone Number*Manager Email* UW-Green Bay Purchasing Test