Applicable for swim team purchases made by a Board Member or a Swim Parent that received prior approval by a Team Co-Lead.

Payment will be reimbursed upon receipt of this form accompanied by your receipt of purchase.

Requester Name

First Name

Last Name

Request Date

MM

DD

YYYY

Pay to the Order of:

Street Address

Amount of Check

Purpose of Check

Approved by Co-Lead (Name)

I will deliver the receipt or proof of purchase to the team's Treasurer:

in person

via email to tracesidebarracudas@gmail.com

N/A

reimbursement form