Online Check/Reimbursement Request Form

PLEASE NOTE: For reimbursement, please submit expenses within 30 days of the event to the Treasurer. Please be sure to use the Prospect PTO tax exempt letter for all purchases.

Date*
Date Format: MM slash DD slash YYYY
Your Name*
First Last
Your Email*
Charge Expense to this Committee*
Description of Expense*
Reimbursement Amount*
Please indicate if reimbursement is required by a certain date.
Date Format: MM slash DD slash YYYY
Reimbursement Method*
- PayPal
- Physical Check
Email associated with my PayPal account

The PTO treasurer will send your reimbursement directly to your PayPal account.
Make Check Payable to:*
Mail Check to:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Note: For teacher reimbursements, please use Prospect address: 100 North Prospect Ave. If the check needs to be delivered or brought to an event, please indicate in the "Note" section below.
Scan or photograph receipts/invoice and attach electronically here.*
Drop files here or

Accepted file types: jpg, gif, png, pdf.
We cannot process payment without appropriate documentation. Accepted file types: jpg, gif, png, pdf. If you take a photo, please make sure the files size is not too large.
Please put any notes to Treasurer here:

Online Check/Reimbursement Request Form

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