Riverwood International Charter School Parent Teacher Student Association

Riverwood International Charter School Parent Teacher Student Association

PAYMENT REQUEST
Directions for Payment Requests or Reimbursement:

Please complete the payment request form below and attach detailed receipt(s). Reimbursements will be received via check within 2-3 weeks.
Date*

MonthDayYear
Date
Requester*

First NameLast Name
Requester Email*
example@example.com
Requester Phone Number*
Please enter a valid phone number
Amount of Payment Request*
Receipt Attached*

OriginalScanned Copy
Budget Category*
Event Description, Date and Purpose of Payment*
Direct Payment To*
Who is the check payable to, or who will receive the credit card payment?
If check, mail to:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Requester's Signature*

Clear
Upload Receipt(s)*

Cancelof
Receipts must be attached to this form and submitted within 15 days of expenditure. Pre-approval must be made for all purchases. Failure to obtain approval my result in purchaser having to incur the expenses. Signature of the PTSA President if required before reimbursement. This form will automatically route to the PTSA President and Treasurer for approval.
Should be Empty: