Pleasant Ridge PTA

Pleasant Ridge PTA Reimbursement Form

For reimbursement of expenses incurred for Pleasant Ridge PTA, please completely fill out this form, including attaching appropriate documentation (copies of receipts, etc).

Alternatively, you may email Melissa Wuestenberg, or print this form and turn it in to the PTA Treasurer's mailbox at Pleasant Ridge.

Full Name

e-mail address

Phone

Check Payable To

Amount Requested

Address to Send Check To

Apartment Number

City

State

Zip

Date of Request

Date Check Needed

Attach your receipts here.
Receipt #1:	Receipt #2:
Receipt #3:	Receipt #4:

Description of Expense(s)