PTO Check Request

PTO Check Request
This form should be used to request a check for a vendor or request reimbursement for an expense from the Lilja PTO.

SHOULD YOU HAVE ANY QUESTIONS, PLEASE CONTACT the PTO Treasurer at treasurer@liljapto.org
Check/Reimbursement Request Information

Please complete all of the information below.
Which of the following describes you
Today's Date*

MonthDayYear
Event/Expense Name*
Total Check Amount*
Check Payable To*
Send/Deliver Check To*
Check Due Date*

MonthDayYear
Is this a RUSH check?*
Requestor Name*

First NameLast Name
Requestor Email*
Requestor Phone Number*

Area CodePhone Number
Documentation (up to 5 may be uploaded)*

Upload a File
Please attach an invoice or receipt(s) images documenting the expense (e.g. receipt, invoice, an email communication, etc.) that has the amount described in the request Cancelof
To Receive Reimbursement via PayPal Enter PayPal email account
Treasurer Initial Approval

Yes
Second Office Approval

Yes
Second Officer Initials
Final Treasurer Approval

Yes
Should be Empty: