Request for funds from Mt Bachelor Quilters' Guild

(if multiple checks are to be written, please provide a separate form for each payee)

Date of Request _________________

Name of Requester_______________________________________

Name of Payee__________________________________________

Address ________________________________________________

_______________________________________________________

Additional Explanation of expense __________________________________________________

_____________________________________________________________________________

Approval – Committee Chairman or Officer ___________________________________________

                  President ____________________________________________________________

Instructions

• Attach original receipts to back of this form (cash register receipts, invoices, contract, all that apply).
• Have approval by Committee Chairman or an officer before submitting to Treasurer.
• Attach Form W-9 to back of this form if payment for services (teacher, speaker, quilter, etc.)

    Treasurer Use Only

Check # ____________ Check Date ____________  Check Amount ____________

Date Bill posted to QuickBooks ____________  Date check posted to QuickBooks ___________