Teacher Reimbursement Request Form

This form is for teachers to submit receipts for reimbursement from the WIS PTO Teachers Discretionary Fund. Each teacher is eligible for $150 per school year.

Instructions:

Please fill out completely - in the description section, provide a simple description of what this is for (e.g. pencils, markers, etc.).
Attach up to 5 files/pictures/scans of all receipts and supporting documentation.
You have the choice to have your check dropped in your school mailbox or sent to your home.
The treasurer will e-mail you when your check is ready in your mailbox/sent home.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
Questions? Please e-mail our treasurer, Lorraine Berger, at treasurer@wispto.com

Check made payable to:

Should the check be mailed or dropped off at school?*

If you would like your check to be mailed, please provide your address:

Total Amount Requested for Reimbursement/Payment:

($150 per school year)

Description/Purpose:

Attach Receipt/Invoice #1

Attach Receipt/Invoice #2

Attach Receipt/Invoice #3

Attach Receipt/Invoice #4

Attach Receipt/Invoice #5