Clay Middle School PTO Reimbursement Request

CLAY PTO REIMBURSEMENT REQUEST
Date

MonthDayYear
Date
Reimbursement Payable To

First NameLast Name
Email Address
Does this expense need additional approval from the PTO Account Holder for reimbursement?
Account Holder Email
Brief description of expense
Amount of Reimbursement Request
Upload Receipts

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
QUESTIONS/CONCERNS?

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

CLAY PTO REIMBURSEMENT REQUEST