Clay Middle School PTO Reimbursement and Check Request Form

Clay PTO Payment Request

Reimbursements/Check Requests/Invoices to be paid
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What type of request is this?
Payable To

First NameLast Name
Email Address of Requestor
Does this expense need additional approval from the PTO Account Holder for reimbursement?
Account Holder Email
Brief description of expense
Amount of Request
Upload Invoices (for check requests) OR Receipts (for reimbursements)

*JPEG/PNG preferred. The PTO is unable to pay reimbursements without a valid receipt.*
Cancelof
Which PTO Fund should this expense be paid from?
Team Expenses
Department Expenses
Event Expenses
Miscellaneous
PTO/Volunteer Expenses
Other/Not Listed
What is your preferred method of payment?
Provide your email, phone number or Zelle tag
Is this for a Clay Staff Member?
Checks will be placed in staff mailboxes.
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list any special requests here.
QUESTIONS/CONCERNS?

Contact the PTO Treasurer at treasurerclaypto@gmail.com
Should be Empty:

Clay PTO Payment Request