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Rotary Request for Payment:
This is a form to use when seeking a special reimbursement of cost from an event, meeting, or other special activity.
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* Indicates required question
Payment to:
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Your answer
Address:
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Your answer
Telephone:
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Your answer
Payment Amount:
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Your answer
Payment For:
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Routine Bill (please describe details below)
Special Event (please describe details below)
Donation (If Approved by Board Action, please provide Date in the details below)
Other (please describe details below)
Payment Description:
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Your answer
Request for Payment Submitted By:
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Request for Payment date: (today's date)
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Your answer
NOTE: With a Smartphone, please take a picture of all invoices, bills, or donation requests and email that document with "REFERENCE TO "details All donations must be approved by the Board prior to payment.
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