ConnPTA_CheckRequestForm.xlsx
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ABCDEFGHIJKLMNOPQRSTUVWXYZ
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CHECK REQUEST FORM
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CONN ELEMENTARY PTA
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* Please attach all receipts.
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DATE:
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NAME:
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EMAIL:
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PHONE NUMBER:
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TOTAL AMOUNT REQUESTED:
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PURPOSE:
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INDIVIDUAL/COMPANY TO WHOM CHECK WILL BE MADE
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NAME:
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ADDRESS:
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(Only needed if mailing directly to individual/company)
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COMPLETE TO SEND CHECK THROUGH YOUR CHILD
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CHILD'S NAME:
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CHILD'S TEACHER/GRADE:
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SIGNATURE:
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(Committee Chair or Executive Board Member)
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* NOTE: This form, including signature, must be completed in its entirety to be processed.
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An incomplete form will result in a delay or inability to reimburse you.
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* NOTE: Do not submit split receipts (personal purchases with Conn purchases).
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