PTC BILL PAY REQUEST FORM

Instructions:

Please fill out completely with description of request and breakdown of expenses.
Attach up to 3 files/pictures/scans of all invoices and supporting documentation.

Filling this out means you understand that all expenditures will be accounted for with sales receipts, invoices, etc in the approved budget category.

Todays Date

PTC Program

Person Making Request

Phone Number

Check made payable to:

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

Address to mail check (if applicable)

Total Amount Requested for Reimbursement/Payment:

Date Check Needed (please allow at least 1-2 weeks if possible):

Special Instructions

Expenses

Invoice

Description of item/event 1

Amount

Invoice 2

Description of item/event 2

Amount

Invoice 3

Description of item/event

Amount

Attach Invoice #1

Attach Invoice #2

Attach Invoice #3