Canyon Rim PTA Check Request

Canyon Rim PTA Check Request
Questions? Email treasurer@canyonrimpta.org

1. Use this form to request payment to a vendor. This is not a reimbursement request

2. Attach an invoice or contract as documentation.

3. All requests must be pre-approved and within the approved budget.

4. Please leave this form in the PTA mailbox in the school office.
Requestor Information
Submitted By:
Date

MonthDayYear
Date
Email:
Phone
Payee (Vendor) Information
Vendor Name
Email:
Phone
Payment Details
Amount Requested
Make Check Payable To
Purpose of Payment
Event/Program (if applicable)
Budget Line Item
Date Payment is Needed

MonthDayYear
Date
Date Payment is Needed

Invoice AttachedContract or Agreement Attached
Requestor Signature

Clear
Date

MonthDayYear
Date
Check Distribution

Give Check to:
Give Check to
Check Distribution

Mail Check to:
Mail Check to
Check Distribution

Other (email treasurer@canyonrimpta.org or text Jen at 480-580-2570 to coordinate)
Received By:
Date Received:

MonthDayYear
Date
Treasurer Use Only
Check Date

MonthDayYear
Date
Check
Amount
Signature

Clear
Should be Empty: