Manhattan Beach Middle School Pta Check Request/reimbursement Form Page 2
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1
2Manhattan Beach Middle School
CHECK REQUEST/REIMBURSEMENT FORM
Please:
1. Attach original receipt(s) or invoice/bill to Request. Be sure to make a copy for yourself.
2. Attach an addressed, stamped envelope if check is to be mailed. OTHERWISE, checks will be available for pick up in the office.
3. Approval for payment is required by either the Principal or PTA Chairperson of committee.
4. Place completed check request/reimbursement form in the Treasurer’s box in the office.
5. Allow up to10 business days for reimbursement.
Date:
Check Written To:
Amount: $
Budget Category/Event Name:
Purpose of Expenditure:
Requested by:
Phone:
Email:
Mail check to
:
(Please see item #2 in instructions above)
Address:
City:
State:
Zip:
Please leave check in my mailbox.
Please leave check in office for pick up.
Store/Vendor
Descrip0on
Cost
Sub
T otal
1-‐
2-‐
3-‐
4-‐
5-‐
Total:
$
All items purchased with PTA funds are considered property of MBMS PTA
"
Dept/Committee Chair Signature:
Date Approved:
Principal Signature:
Date Approved:
PTA President:
Date Approved:
This section to be completed by the Treasurer.
Check#
Date:
/
/
Account:
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Parent category: Business