Hayes PTO Expense Reimbursement Request
Submitted by
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First Name
Last Name
E-mail
*
Date
*
/
Month
/
Day
Year
Date
Expense Category
*
Please Select
Assemblies
Book Fair
Clothing
Cookies & Create
Corresponding
Donuts & Coffee
Family Fun Nights
Fifth Grade Grade
Field Day
Field Trip Bus Fare
Holiday Craft Week
Kinder Bus Fare
Membership
Miscellaneous
Office Supplies
PTO Meetings
Spring Clean Up
Staff Appreciation
T-Shirts
Veteran's Day
Other
Describe Expense
*
List items purchased
Amount
*
Do not include Sales Tax (cannot be reimbursed)
Take a Photo of Your Receipt (Usually for a Smartphone)
Upload a File with Your Receipt (Usually for a PC)
Signature
*
Method of Delivery
*
Mail
Send home with student
Delivery Info
Enter Address or Child's Name & Teacher
Submit
Should be Empty: