Reimbursement Request Form

Fill in this form to request payment for:

Expense Reimbursement – must attach receipts
Vendor Payments – must attach invoice/PO
Funding Advance – for event cash box, or pre-payment

The form will be sent to the Treasurer for processing. You should receive immediate email confirmation, but may be contacted for follow-up clarification, so please provide correct contact information.

– FFO Treasurer (email)

School Network & Attachments: Uploading receipts from a school network may be blocked. If you have problems, please try a personal mobile device or network. Thanks!

Name

First Name

Last Name

Email

For confirmation, status updates, and questions

Phone

(###)

###

####

Payable to:

First Name

Last Name

Amount

$

Type

Expense Reimbursement

Vendor Payment (Invoice / PO)

Fund Advance

Justification

Please share the reason for this payment: Budget Line Item, Teacher discretionary, Field Trips, Grants, Staff Appreciation, etc)

Delivery Location

eCheck (Please email me an electronic check to print)

Box at School (Please deliver to my mailbox in the school office)

Mail me a check

By checking this box, I certify this request is accurate and describes a valid use of FFO funds.