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 files Accepted file types: jpeg, jpg, gif, png, pdf, doc, docx, rtf, txt, Max. file size: 512 MB. Accepted formats: jpeg, jpg, gif, png, pdf, doc, docx, rtf, txtComments:CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
