24/25 PTSA Payment Authorization / Request for Reimbursement

This form should be used to request direct vendor/supplier payments for PTSA approved programs/activities or to request reimbursement towards money spent for PTSA approved programs/activities.

In accordance with PTSA guidelines, gift cards are not approved expenses and will not be approved for reimbursement.

Instructions:

Fill out the form completely, including a description of reimbursement and breakdown of expenses.
Attach all supporting receipts and/or invoices, which are required for all requests.
A receipt of your submitted request will be emailed to you (please keep for your records).
The treasurer will contact you when your payment is ready to be picked up or is mailed.
PTA funds cannot be used to purchase gift cards

Note: Whenever possible, please keep your reimbursed expenses on a separate receipt/transaction from your personal expenses to help expedite the processing of your reimbursement. Otherwise, all submitted line item expenses need to be highlighted with the total reimbursement request noted on the receipt.

Payments: Requests will be reviewed bi-weekly on the 1st and 3rd Wednesdays of each month. Payments will be issued on the Fridays of those weeks. Please reach out if you have a time-sensitive request that falls outside of this schedule.

Questions? Please email: treasurer@cadenceparkptsa.org

Write check payable to (Name of Person/Company): (required)

Address (if check is to be mailed)

City

State

Zip Code

Telephone (required)

Payment Request (required)

Mail check Check to be picked up at Next PTSA Meeting

Funds Needed by

Name of Person Requesting Check

PTSA Position

If you selected "Other", please include details:

Telephone: (required)

Activity or Event Name (required)

Total Amount Requested (required)

Expense - Line Item #1 (Include: 1. Vendor/Business Name, 2. Description, 3. Amount)

Expense - Line Item #2 (Include: 1. Vendor/Business Name, 2. Description, 3. Amount)

Expense - Line Item #3 (Include: 1. Vendor/Business Name, 2. Description, 3. Amount)

Expense - Line Item #4 (Include: 1. Vendor/Business Name, 2. Description, 3. Amount)

Expense - Line Item #5 (Include: 1. Vendor/Business Name, 2. Description, 3. Amount)

Expense - Line Item #6 (Include: 1. Vendor/Business Name, 2. Description, 3. Amount)

Attach Receipts

If you have multiple receipts for this request, please attach additional receipts below or create a multi-page document.

Attach Receipts

Attach Receipts 6