Pinewood Preparatory School - DOC by kBPs35H4

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									                 Azalea Sertoma Club of Summerville
                            Check Request
Check Date:___________                                   Request Date:_____________
                                                         Total Amount: ____________
                                                         Deadline Date:_____________
Return Check to requester ____                           Purchase Order#___________
Mail to payee             ____

Make Checks Payable To:                          Acct#          Amount          Check#
(If it is to be mailed include address)         League & Team


__________________________                       ________ $__________ _________

__________________________                       ________       $_________ _________

__________________________                       ________       $_________ _________

__________________________                       ________       $_________ __________

__________________________                       ________       $_________ __________


Explanation

_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

                                                                 Authorized
                                                                 _________________
                                                                 Requested by

                                                                  _______________________
                                                                  League Commissioner
Note: You must have an invoice for all items.
                                                                  _______________________
                                                                  Treasurer/Account Chair

								
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