CANS PTO Reimbursement Request
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Reimbursement Request
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Clifton Area Neighborhood School PTO
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Name of Requester (Check will be paid to this name):PHONE:
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PROJECT/CATEGORY:
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REASON FOR REIMBURSEMENT:
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Total amount of reimbursement requested
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FULL ADDRESS (your check will be mailed to you):
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Receipt(s) totaling the amount of reimbursement must be included and this request signed.
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Signature of Requester (Or attach email*):DATE:
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Details below double line to be completed by PTO Officers.
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INCLUDED IN
ANNUAL BUDGET
orAPPROVED AT MEETING
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DATE:
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APPROVED BY (PTO OFFICER SIGNATURE OR ATTACH EMAIL*):DATE:
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APPROVED BY (PTO OFFICER SIGNATURE OR ATTACH EMAIL*):DATE:
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FOR TREASURER'S USE ONLY: Category _________ Check # __________ Date _____________ Logged _____________
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*EMAIL FROM SIGNATORY TO PRESIDENT, TREASURER, AND SECRETARY OF CANS PTO CAN BE
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SUBSTITUTED FOR AN ORIGINAL SIGNATURE.
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