Email

Where to Send Check (or Pickup in PTA Mailbox)? (If going to a Vendor, please leave their name/address)

If check is going to the Vendor OR a Debit Card transaction, fill out this section (otherwise leave blank):

REQUIRED: PLEASE ATTACH INVOICE(S) BELOW

Vendor Name

Invoice or Order Number:

Total Amount of Invoice (excluding sales tax)

$

Description of Service and/or Event

If YOU are getting reimbursed, fill out this section (otherwise leave blank):

REQUIRED: PLEASE ATTACH INVOICE(S) BELOW

Check Made Out To:

Total Amount of Receipts (excluding sales tax)

$

Reason for Request:

Description of Service and/or Event

Specialty Project or Other:

PTA Reimbursement Check Request Form

Harvard Elementary PTA