Payment Request Form Team/Committee:*Total Amount of Receipts:*For the Purchase of:*From:*General FundCapital FundMission & Service FundGifts & Memorials FundGood Samaritan FundIf this expenditure was approved, by whom?Goods and/or services received by:*On This Date:* MM slash DD slash YYYY Payee's First Name:*Payee's Last Name:*Email:* Phone:*Method of Payment:*ChequeDirect DepositE-TransferPetty Cash (if under $50.00)Address:* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Please list where invoices or receipts are from:*Attach Files: Drop files here or Select filesAccepted file types: jpeg, jpg, gif, png, pdf, doc, docx, rtf, txt, Max. file size: 16 MB.Accepted formats: jpeg, jpg, gif, png, pdf, doc, docx, rtf, txtComments:CAPTCHANameThis field is for validation purposes and should be left unchanged.
