Q Check Request (Must Be Accompanied by an Invoice Or Quote)

l Page 2 November 21, 2013

Name:
Pay to the order of:
Amount:
Need by Date:

This is a:

q  Check Request (must be accompanied by an invoice or quote)

q  Reimbursement Request (must be accompanied by a receipt, attached to back)

How would you like your check?

q  In my school mailbox

q  By mail

Address: ______

______

Committee (check one):

q  Programs
q  Membership
q  Ways & Means
q  Volunteers
q  Correspondence/Newsletter / q  Dads Club
q  Fifth Grade Committee
q  Five Star
q  SAC
q  Other

Event (or other): ______

______

PTA Committee Chair PTA Executive Board Liaison

All forms must be filled out in full and accompanied by the proper receipts/invoices. All check requests (other than personal reimbursements) should allow 3 business days to be processed. In case of urgency, please contact the PTA Treasurer by email:

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For Treasurer’s Use Only

Date Paid ______

Check # ______

Amount ______