Check / Reimbursement Request

advertisement

Check / Reimbursement Request

The receipt(s), bill, quote, or statement for the total amount MUST be attached for a check to be issued.

Date Submitted: __________________ Project / Committee: _______________________

Your Name: ________________________________ Phone: _____________________

Email: _______________________________________________

Check Payable to:

___________________________________________________________________

Amount: $________________________

Description of expenditure: _____________________________________________________

Have you attached the receipt(s), bill, quote, or statement?

How should the check be delivered?

Yes No

Mail to (include entire mailing address):

________________________________________________________________________

Back Pack Mail ____________________________________________________________

Child’s Name Teacher Grade

---------------------------------------------------------------------------------------------------------------------------

For Treasurer’s Use Only

Included in annual budget

1 st PTO Officer Approval: ________________

2 nd PTO Officer Approval (if over $1000):___________________

Check # ________ Date: _________ Mailed: _________

Download