Advance Request Receipt Form

Advanced Request Receipt Form

Use this form if you have requested money $$ before you purchased items.
Are you completing receipts from a previous request, or is this a new request?*

Previous requests - receipts for remaining fundsNew Submission
Please READ Instructions:

(1) Please list each request you made individually, so we can track the specific expenditure.

(2) When uploading receipts, please make sure that the image is clear for all Parents Challenge approved items.

(3) If you have receipts that include other items, please highlight the Parents Challenge approved items.
Parents Name:*

First NameLast Name
Scholar Name 1: *

First NameLast Name
Scholar Name 2:

First NameLast Name
Scholar Name 3: Parent Coordinators ONLY

First NameLast Name
Total Amount Received:*
Date Check Was Issued:*

MonthDayYear
Amount of Money not spent:*
If you have not spent the full amount, please put in how much is left. If no money is left, put 0. The money not spent can be kept and utilized for approved expenditures on the next request.
How Monies were Spent: *
Please list the items purchased from receipt(s) with the amount spent (be specific).
Receipts:*

Upload a File
Please upload receipt for the item(s) listed above. Cancelof
Receipts:

Upload a File
Please upload receipt for the item(s) listed above. Cancelof
Receipts:

Upload a File
Please upload receipt for the item(s) listed above. Cancelof
Should be Empty:

Advanced Request Receipt Form