ABCDEFGHIJKLMNOPQRSTUVWXYZ
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HERITAGE HIGH PTSA
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FUNDS RECEIVED FORM
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Date:_____________________________________
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Budget Category:
.
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Membership:
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Students
___$_______________
Husky Nights:
___$_______________
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Parents
___$_______________
Location:
___________________
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Staff
___$_______________
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Other
___$_______________
Retail Rebates:
___$_______________
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From: (circle below)
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Harris Teeter
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Husky Donations:
___$_______________
Lowes
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Amazon Smile
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Special Activities:
___$_______________
Other:
___________________
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Bricks:
___$_______________
Other Source:
___$_______________
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Category:
___________________
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TOTAL:
_____________________________________________________
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Funds Received:
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Coin:
___$_______________
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Currency:
___$_______________
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Checks:
___$_______________
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Auto Deposit:
____________________
(second signature not required)
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TOTAL:
_____________________________________________________
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Signature of Counter:
________________________________________________________
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Signature of Witness/Counter:
________________________________________________________
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