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2017-18 DAIS PTO Disbursement Requests
Please complete this form when requesting monetary reimbursement from the DAIS PTO. A copy of the receipt must be provided to the PTO for reimbursement. You may provide a copy of the receipt to your community office (attn: DAIS PTO) or email the receipt to
daispto@dallastown.net
.
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* Required
Name of person requesting reimbursement
*
Your answer
Email address
*
Your answer
Amount being requested for reimbursement
*
Your answer
Reason for reimbursement
*
Your answer
Student Information (Name, Team, Homeroom)
*
Your answer
How would you like your reimbursement:
*
Choose
Mailed (*If you select this option, please complete the question below.)
Sent home with student
Mailing address for reimbursement
Your answer
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