Check Request/Reimbursement Request Form

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
Attach up to 3 files/pictures/scans of all receipts and 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 or has been mailed to you.
Questions? Please e-mail our treasurer, John Palusci at thoreauschoolptgtreasurer@gmail.com.

As always, please remember: As a sales tax exempt organization so please give all vendors a copy of our sales tax exemption form to avoid being charged sales tax when you make your purchase.

First & Last Name

Check made payable to:

Should the check be mailed directly to the vendor/payee or dropped off at school?*

Provide address if needs to be mailed:

Total Amount Requested for Reimbursement/Payment:

Committee/Event/Teacher Stipend*

Description/Purpose:

Attach Receipt/Invoice #1

Attach Receipt/Invoice #2

Attach Receipt/Invoice #3 (if you have more than 3 please send ALL invoices to the PTG Treasurer via email):

Date Check Needed (please allow at least 1-2 weeks if possible): Did you remember to attach or send your invoices/receipts? :)

Attestation

By submitting this form and checking the box above, I confirm that all items in this request are for the purpose stated above, no personal purchases are included, and any items purchased for classroom or school use will become school property.