PTO Check Request Form
Note: This form is to be used for expenses incurred for PTO activities – not for Teacher
Pin money. All Teacher Pin money requests must be on a separate form and forwarded to
the School’s Business Office.
Procedures:
Fill out form below and attach all receipts. If expenses were incurred for more than one
PTO activity, please designate amounts for each activity.
Have activity chairperson or PTO Chair approve expenses and sign form.
Return this form to the PTO Treasurer by email or through the PTO mailbox at either
campus.
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Date of request: ________________
Amount requested: ___________________
Requested by: ____________________________________________________________
PTO activity for which expense was incurred: __________________________________
________________________________________________________________________
Make check payable to: __________________________________________________
Date check needed by: _______________________
Preferred check delivery method (e.g. mail to [address], send home with child, etc.):
________________________________________________________________________
________________________________________________________________________
Signature of chairperson/PTO Chair:
Amount paid
Check #
Date