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- Payment Reimbursement Form

The Leffell School PTO

Enhancing and enriching our school community by volunteering and partnering together.

Payment Request Form

First name

Email

Request Type

Reimbursement

Invoice

Zelle ID (email or phone number)

Expense Date

Last name

Phone

Payment Method

Zelle (preferred)

Check by mail

Already paid and form is for documenation purposes

Payee Name (if different from above)

Total Amount

Event or Program

Description or Notes

Number of Receipts

Receipt 1 - Format

PDF or Word File

Image

Receipt 1

File

Upload supported file (Max 15MB)

Receipt 1

Image

Upload supported file (Max 15MB)

Receipt 2 - Format

PDF or Word File

Image

Receipt 2

File

Upload supported file (Max 15MB)

Receipt 2

Image

Upload supported file (Max 15MB)

Receipt 3 - Format

PDF or Word File

Image

Receipt 3

File

Upload supported file (Max 15MB)

Receipt 3

Image

Upload supported file (Max 15MB)

Receipt 4 - Format

PDF or Word File

Image

Receipt 4

File

Upload supported file (Max 15MB)

Receipt 4

Image

Upload supported file (Max 15MB)

Thanks for submitting! We will process your request as soon as possible.

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Contact Us

pto@leffellschool.org

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Last Name

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Email

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