LL - Form E - Request for Withdrawal of Local League Ed Funds

LL - Form E - Request for Withdrawal of Local League Ed Funds
Date:*

MonthDayYear
Date
Local League:*
Project Title*
Request Type
Information for person preparing request
Name

First NameLast Name
Position
Phone Number

Area CodePhone Number
Email
example@example.com
Local League Treasurer
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Make check payable to
Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount requested
Amount requested*
Describe purpose of payment or expenses to be covered if they are not itemized on a final report submitted with this request.*
If you have scans or photos of the receipts, you may attach them below. If you cannot make these digital files, you can mail the receipts (or copies of the receipts) to the LWVWA office in Seattle. Receipts are not required for an initial request to initiate the project.

Upload Files

Cancelof
Local League President Approval
President has approved this request
Name of Local League President *
Email*
example@example.com
After you click the submit button below, you will receive an email confirmation with a PDF of the information you just submitted attached. Please save this document for your files, along with a copy of your receipts.

If you need to mail in your receipts, please print out that PDF and mail it along with the receipts to:

Amy Peloff
League of Women Voters of Washington Education Fund
1511 3rd Avenue, Suite 801
Seattle, WA 98101
Should be Empty:

LL - Form E - Request for Withdrawal of Local League Ed Funds

Information for person preparing request

Local League Treasurer

Make check payable to

Amount requested

Local League President Approval