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  • Debtor/Parent Information

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  • Girl Information

  • Attempts to Collect

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    Use log below to enter the dates of communication with the parent regarding payment of the amount due.

    Use the additional space provided to provide the details of your collection efforts. 

    Note: 5 attempts to communicate and recoup the balance due with at least 3 attempts in writing is required.

  • Upload all supporting documents below. These documents should include signed Parent Permission & Financial Responsiblity Form, signed receipts for products issued/received, signed receipts for payments made, proof of communication of debt/balance due, etc. (All file types accepted)

  • Leader/Program Manager Info.

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  • Review & Submit

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