• 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


    Green Team 

    Health Rm/Growth & Dev

    Mentoring Program 

      Misc Fundraiser

      Movie Night

    Pumpkin Chuck


    Staff Conference Meals

    Staff Appreciation Week

    Staff Holiday Meal/Gift

    □ Staff Project Request

    □ Student Directory

    Variety Show 

    Volunteer Appreciation


    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. 


    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