100 East Third Street, P.O. Box 578 Piketon, Ohio 45661 Phone: 740-289-4171
475 Western Avenue Chillicothe, Ohio 45601   Phone: 740-702-3120
View Ross Pike ESD & SST 15
ROSS PIKE SPECIAL EDUCATION WALMART PURCHASE REQUEST
Prior to making a purchase with the Wal-mart credit card, the following online form must be completed, and approved by your immediate supervisor.


Teacher Name
Date of Request
Purpose for purchase
Supervisor who needs to approve




Email where you prefer the reply
Corresponding Purchase Order Number
Please list items that you intend to purchase
Your Name:  
Your Email:  

To validate your submission, please type the answer to the following question:


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