Name:
Address:
Phone Number:
Date:
Committee:
Items Purchased:
Reason For Purchase:
Cost Of All Items:
(Please Attach ALL Receipts)
Signature:_______________________________
Date:________________
- Note: No money will be reimbursed without the original receipt attached to the form.
- The request form will be discussed and voted on by the entire group at the meeting one week after it is turned in. A 2/3 vote from the group is needed to approve request.
- Money will be given promptly if available funds can allow it.
- All money will be reimbursed by check form only; no cash will be given at any time.
Officer Use Only
Date Requested:
Approval:
Date Returned:
Check Number:
Treasurer Signature: _______________________________ Date: ____________________
President Signature: _______________________________ Date: _____________________