American Chemical Society Cleveland Section
Required Form for
Deposit of Funds and Requests for Disbursements
Print Name
Amount for deposit or amount requested $
Explanation of activity
Please check one and only one of the following permissible categories
Deposits
Ad Income
Local Dues
National Chemistry Week
Chemistry Olympiad
Dinner Receipts
Miscellaneous
Disbursements1
Awards
Special Projects
Morley Meeting
Heller Award
NE Ohio Science Fair
Meetings
Dinners
Rent, Proj., Park, etc.
Speakers Expenses
Administration Chair’s Expenses
Isotopics
Secretary
Treasurer
Section Officer Meetings
Government Affairrs
CTSC Dues-Dinners
50 Year Member Dinner
Include receipts
Committees Archive/Historian
By Laws
Chemistry Olympiad
Career Services
High School Affairs
Membership
National Chemistry Week
Meeting in Miniature
Public Outreach
Program Chairman
Student Affiliates
Younger Chemists
Other
Signature and date
Deposited by Treasurer (date)
Paid by Treasurer (date)
Mail to:
Email: jmoran@ndc.edu
John Moran
Treasurer, Cleveland Section ACS
c/o Notre Dame College
Department of Chemistry
4545 College Rd.
South Euclid, OH 44121
1
Councilor Reimbursement requires special form
check number
Mail Reimbursement to: