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SCMS PTO Reimbursement Request

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
Attach a file/picture/scan of each receipt or supporting documentation.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
The treasurers will e-mail you when your check is ready to be picked up at the school or has been mailed to you.
Questions? Please e-mail our treasurer at treasurer@scmspto.com.

Name

Email

Staff?*

For Staff Only: Grade/Department

Grand total amount for reimbursement:

How would you like to receive your check?*

Vendor

Expense category*

Brief description of items purchased

Subtotal

Shipping

Tax

Total

Attach receipt

Vendor

Expense category

Brief description of items purchased

Subtotal

Shipping

Tax

Total

Total

Attach receipt

Vendor

Expense category

Brief description of items purchased

Subtotal

Shipping

Tax

Total

Attach receipt