Pta Check Request Template

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_____________________ PTA
Request for Check
Submitted by
Type of Request
 Unit Academics
 Field Trip*
 Special Grant Request
 PTA
*see back
(requires a membership vote)
Date of Request
Teacher, Grade, Committee or Event to be charged
Describe Expense
(* For field trips use the back, do not write below)
Refund
Make check payable to:
Send check to:
Name/Vendor
Name
Address
Address
City/State/Zip
City/State/Zip
Phone
Phone
Check amount
By this date
Authorized by _____________________________________
Date ___________________
PTA President
For Treasurer’s Documentation
Check number:
Date:
Documentation or receipt attached?
YES
NO
10/18/11ML
_____________________ PTA
Request for Check
Submitted by
Type of Request
 Unit Academics
 Field Trip*
 Special Grant Request
 PTA
*see back
(requires a membership vote)
Date of Request
Teacher, Grade, Committee or Event to be charged
Describe Expense
(* For field trips use the back, do not write below)
Refund
Make check payable to:
Send check to:
Name/Vendor
Name
Address
Address
City/State/Zip
City/State/Zip
Phone
Phone
Check amount
By this date
Authorized by _____________________________________
Date ___________________
PTA President
For Treasurer’s Documentation
Check number:
Date:
Documentation or receipt attached?
YES
NO
10/18/11ML

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