Focus Blue Card Request Form

Use the form below to request a Focus Blue card, a prepaid debit card issued by U.S. Bank and administered by UW–Madison’s Travel and Card Team, when other payment mechanisms are impractical or unavailable. More information about Focus Blue Cards

Please explain the UW–Madison business purpose for this expense.(Required)

Number of Focus Blue cards required(Required)

Card delivery method(Required)

Recipient picks up from Accounting Services (21 N. Park Street, Suite 5301)

Card custodian picks up from Accounting Services (21 N. Park Street, Suite 5301) and distributes to recipient(s)

U.S. Postal Services (USPS)

Name of card custodian who will pickup cards(Required)

First Last

USPS delivery of Focus Blue cards(s)(Required)

Deliver to department address

Deliver to recipient(s)

Department address(Required)

Street Address Address Line 2 City State ZIP Code

Focus Blue Card details

You can submit information (card amount, recipient name, recipient date of birth, and recipient mailing address) for up to five Focus Blue cards with this request. Requests greater than five cards require you to upload a document (e.g., Word, Excel) with the noted information.

Number of Focus Blue cards being requested(Required)

Card #1 - Dollar amount(Required)

How much money is put onto the card.

Card # 1 - Recipient name(Required)

First Last

Card #1 - Recipient date of birth (DOB)(Required)

Card #1 - Recipient Mailing Address(Required)

Information required even if card is not being mailed.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Card #2 - Dollar amount(Required)

How much money is put onto the card.

Card # 2 - Recipient name(Required)

First Last

Card #2 - Recipient date of birth (DOB)(Required)

Card #2 - Recipient Mailing Address(Required)

Information required even if card is not being mailed.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Card #3 - Dollar amount(Required)

How much money is put onto the card.

Card #3 - Recipient name(Required)

First Last

Card #3 - Recipient date of birth (DOB)(Required)

Card #3 - Recipient Mailing Address(Required)

Information required even if card is not being mailed.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Card #4 - Dollar amount(Required)

How much money is put onto the card.

Card #4 - Recipient name(Required)

First Last

Card #4 - Recipient date of birth (DOB)(Required)

Card #4 - Recipient Mailing Address(Required)

Information required even if card is not being mailed.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Card #5 - Dollar amount(Required)

How much money is put onto the card.

Card #5 - Recipient name(Required)

First Last

Card #5 - Recipient date of birth (DOB)(Required)

Card #5 - Recipient Mailing Address(Required)

Information required even if card is not being mailed.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Documentation for Focus Blue card requests(Required)

Required for submitting requests greater than five (5) cards. Please include the following for each requested card: dollar amount for card, the recipient's name, recipient's date of birth, and mailing address. Uploaded information can be in Word (docx) or Excel (xslx) formats.

Accepted file types: xslx, doc, docx, Max. file size: 24 MB.

Submitter information

Name of submitter(Required)

First Last

Name of Department/Division(Required)

Submitter email(Required)

Used to send you a copy of your request submission and for follow-up information about card funding.

Submitter phone

This field is for validation purposes and should be left unchanged.