KBC PTO Check Request/Reimbursement Form
Please complete this form to be reimbursed or request a check for future purchase. After the form is filled out, please email a picture or pdf of your receipt to the KBC PTO Treasurer at
to complete your request.
Name of Person Submitting Request
Committee or Grade Level
Make Check Payable to (if other than person submitting)
Purpose of Expense
Is this a budgeted or approved item?
Instructions for Check Payment
Leave check in Committee/Teacher box
Send check home with child
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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