Request Reimbursment Online

Use this form to submit a reimbursement request to the Kolter PTO Treasurer.

Date
MM
DD
YYYY
Requestor's Name*
FirstLast
Requestor's Email*
Mailing Address
Street AddressCityStateZip Code
You must specify an address if you wish to receive a check via US Mail.
Purpose of Expense and Details*
Please list individual receipts/invoices and amounts per line. Example:
Office Max $10.81
Target $21.23
Total
Total amount being requested for reimbursement
Desired Payee for Check
- Requestor
- Vendor
- Other
Requestor - used for reimbursement of expenses
Vendor - used for direct payments to vendors
Other - specify in Comments
Desired Payment Method
- Teacher/Staff Mailbox
- U.S. Mail
Upload Receipts
Upload 1 file (jpg, gif, png, or pdf) that contains ALL the scanned receipts pertaining to this request. If you are unable to upload a file, place your supporting receipts in the Treasurer's envelope in the PTO drawer at the Kolter front office.

Kolter Elementary PTO