Check Request/Reimbursement Request Form

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
You must attach a file/picture/scan of each receipt or supporting documentation.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
The treasurer will e-mail you when your check is ready to be picked up at the school.
Teacher reimbursements go through our principal Mrs. Parker.
Questions? Please e-mail treasurer@sagecanyonpta.org.


Information
Name of person filling out form: Phone Number Email Address: Check should be written to: Grand total amount for reimbursement:

Receipts
Vendor #1 Expense category* Amount Brief description of items purchased Attach receipt Vendor #2 Expense category Amount Brief description of items purchased Attach receipt Vendor #3 Expense category Amount Brief description of items purchased Attach receipt Vendor #4 Expense category Amount Brief description of items purchased Attach receipt Vendor #5 Expense category Amount Brief description of items purchased Attach receipt