Date:_______________________
PTG EXPENSE REIMBURSEMENT REQUEST
Committee _____________________________________________________________
Committee Chairperson Approval ____________________________________________
Person Requesting Reimbursement ___________________________________________
Mailing Address __________________________________________________________
__________________________________________________________
Telephone Number ________________________________________________________
Reason/Item for Request ___________________________________________________
________________________________________________________________________
________________________________________________________________________
Total Amount of Reimbursement ____________________________________________
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Receipt(s) must be attached and equal the total amount of reimbursement
requested to be processed. 
All requests must have chairperson approval
All requests must be submitted to the PTG Treasurer via the PTG mailbox in an
envelope marked “PTG Treasurer – Expense Reimbursement Request” or hand
delivered directly to the treasurer.
TREASURER’S USE ONLY
Payable To _________________________________________________________
Check Number _____________________
Check Amount _____________________
Date of Check ____________________