ADHS CHORAL BOOSTERS

CHECK REQUEST FORM

 

Date: ______________

 

Requested by: __________________

 

Authorized by: __________________  (Joy Clayton, Choral Booster President or Treasurer)

 

 

Pay to: ____________________

 

Payee’s Mailing Address: _____________________

                                                _____________________

                                                _____________________

 

Indicate alternate way of delivering payment if not to be mailed:  _____________ ___________________________________________________________________

 

 

Amount of Payment:  $______________

 

Date Needed:  _________________

 

Purpose of Expenditure: ____________________________________________

 

NOTE:  Attach all receipts or invoices validating this request to this form

 

*   *   *   *   *   *   *

(This section to be completed by Treasurer)

 

 

Account Name Posted To: _________________________

 

PAID BY CHECK #___________    DATE: ___________