• Payment Request Form Blue Ash Elementary PTO 

    Amount of Expense: _______________________________________ Date: ________________________

    Check payable to:  ______________________________________________________________________ 

    Mail check to:  ___________________________________________________________________ US postal address 

     __________________________________________________________________________________________ 

     

    Submitted by:  ______________________________________________________________________

    Chairperson’s signature: __________________________________ Date: _________________________ 

    Your contact information (email/phone): ______________________________________________________ 

     

     

    SOURCE OF FUNDS:  Check the appropriate budget or committee category from the list below. If the item is to  be expensed to a sub-committee, explain below (i.e. Haunted Fest ~ Prizes) 

    □ 4th Grade Celebration

    □ Active Aves 

    □ Author Visit 

    □ Cultural Event

    □  Donut Days

    □ Family Dance

    □ Family Fun Night 

    □  Field Day

    □ Garden 

    □ Green Team 

    □ Health Rm/Growth & Dev

    □ Mentoring Program 

    □  Misc Fundraiser

    □  Movie Night

    □ Pumpkin Chuck

    □  Read-a-thon

    □ Staff Conference Meals

    □ Staff Appreciation Week

    □ Staff Holiday Meal/Gift

    □ Staff Project Request

    □ Student Directory

    □ Variety Show 

    □ Volunteer Appreciation

    □ Yearbook

    □ Other: _____________________________________________

     

    Sub-committee/Explanation for above:  _________________________________________________________ 

     

    Print this form, attach receipts and drop off to the Blue Ash Elementary office during school hours.  RECEIPTS MUST BE ATTACHED FOR PAYMENT! Direct billing by companies to the Treasurer is preferred when possible. Please forward this complete form and receipt(s) to

    Attn: PTO Treasurer

    Treasurer’s Folder 

    mailbox in the school office 

    Please call email (baptotreasurer@sycamoreschools.org) if you need immediate payment. Checks are written approximately every two weeks. 

    BLUE ASH PTO IS TAX EXEMPT 

    TAX EXEMPT ID# 45-5306908 

    You will NOT be reimbursed for any sales tax paid! Use the above Tax ID number when purchasing.

    Treasurer Use Only 

    Check #: ____________ Date Written: ____________



    Rev. 9/26/2016