Authorization for Expenditure of Funds
DATE HOLD MAIL
Make check payable to:
NAME
ADDRESS PHONE# E-MAIL
CITY STATE ZIP
NAME OF ACCOUNT TO BE CHARGED
Club Advisor: _____________________________________________________________________________
Type/Print Name Signature Ext.
Club Representative: _______________________________________________________________________
Type/Print Name Signature Phone
A.S. Officer: __________________________________________ Date: __________________________
Signature
Dean of Student Affairs: _________________________________ Date: __________________________
Signature
Clerk: ___________ Acct Balance: ___________ Check Number: __________ Check Date: _____________
FAILURE TO PROVIDE
THE ABOVE MAY CAUSE
DELAYS IN PROCESSING
DESCRIPTION
Quantity
Unit
Price
Amount
Additional Information /
Documentation Required:
Minutes - highlight
approval of expenditure
Description/Details of
purchase/service rendered
Date & Name of activity
Attach all Original
Receipts/Invoices
Received by:_________________________
Date Received/Mail:___________________
Tax
Shipping
TOTAL
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome