CCI Debit Expenditure Request Form
Submit this form to request a debit card expenditure from the PTA. If this expenditure is to pay an bill electronically, you will need a photo or screenshot of an invoice to upload when submitting the form.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Total Amount Requested
*
Vendor Name
*
(Short description of what's being purchased)
Budget Category
*
Please Select
2 - PTA Management
3 - Department Discretionary Funds
5 - Student Support
6 - Teacher/Staff Support
7 - Facilities
PTA Management Subcategory
*
Please Select
Insurance
Software
Website/Domain/newsletter
PTA Office Supplies, Printing & Postage
Tax Preparation
Bank Fees
Volunteer & Member Recognition
PTA Leadership Development
PTA Discretionary Fund
NCPTA Dues
Department Discretionary Funds Subcategory
*
Please Select
Business/Marketing (CTE)
Counseling
EC
School Social Worker
Science CEC
Science ONE
Math CEC
Math ONE
Social Studies CEC
Social Studies ONE
English CEC
English ONE
Office
Library
Public Relations
Student Support Subcategory
*
Please Select
CCCC Student Programs & Celebrations
College Preparation
Student Events
Planners
Field Trips
Prom
Senior Celebration/Graduation
Student Leadership Development
Student Programs & Celebrations
Student Recognition
Teacher/Staff Support Category
*
Please Select
Principal's Discretionary Fund
Staff Appreciation
Facilities Subcategory
*
Please Select
Facility Improvements
Please fill in Amount (+ estimated sales tax) and Purpose of Expense below:
Rows
Purpose and use of purchased items
Amount
1
2
3
4
If there is an invoice to pay via debit card, please upload a copy here. File types accepted: PDF, jpg, jpeg, doc.
Browse Files
Drag and drop files here
Choose a file
PDF, jpeg, jpg, doc
Cancel
of
Any additional information or questions:
Submit
Should be Empty: