EDEN HALL

PTO Teacher Reimbursement Form

Classroom Start-Up Expenses

2009 - 2010 School Year

Date:

 

 

 

 

Name:

 

 

 

 

Email:

 

 

 

 

Grade (circle):

4

5

6

 

 

 

 

 

Procedures:

 

 

 

·         Tape the original detailed receipt for each purchase to the back of this form or to another sheet of paper.  Please do not staple receipts to this form.

·         Circle or highlight the amounts each receipt requested for reimbursement.

·         Place this completed form and receipts in an envelope addressed to PTO Treasurer and place in the PTO mailbox located in the front office.

·         Faculty members should photocopy reimbursement requests and receipts for their own records.

·         **Faculty members must submit their reimbursement request for up to $50 by 10/31/2008.***

·         Reimbursement checks will be placed in the faculty member’s school mailbox within 10 days of receipt.

Date of Purchase

Description

Total $ Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Due:

$

Questions?

Treasurer:

Jodi Mann

Assistant Treasurer:

Terry Pomerleau

email:

klvoit4@hotmail.com

jodimann@yahoo.com

home:

(724) 799-2076

(724) 444-6010

cell:

(724) 612-4008

(724) 816-2568