Hill PTA Reimbursement and Check Request Form Online SubmissionName* First Last Email* Enter Email Confirm Email Phone*Reimbursement Amount Total*Today's Date* Date Check Needed*"Checks are issued weekly. If you have an urgent request, please add that in the notes. Otherwise expect your check within 7 days" Make Check Payable To*"First and Last Name or Company Name"Address (Check Delivered To)*Hill Elementary (all teacher reimbursements will be delivered to school weekly)Other Address (List Below)Other Address (Check Payable To)* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account to be debited*If you don't know what account to charge, describe what the purchase is forItemized RequestsIf your invoice reflects more than one account, please identify each and the amount that should be deducted from each. Remember to use the sales tax exemption certificate when purchasing items for PTA use. SALES TAX WILL NOT BE REIMBURSEDItemPlace of PurchaseAmountTotal RemarksAttach receipt(s) Drop files here or Accepted file types: jpg, gif, png, pdf.