Payment/Purchase Request

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Please fill out this form if you need a reimbursement check for items you purchased OR if you need an invoice to be paid out of your sport-specific account. A receipt or invoice is required before any funds will be dispersed. Please plan ahead if you need Boosters to send a payment. All payments are made through a check and it takes 7-10 days for checks to be written and mailed once this form is submitted. Confirm with business/supplier they will accept a check before placing an order. Otherwise, you may be liable for products/camps/etc. ordered.

Email *

Coach Name *

Sport

Date of Request *

YYYY

What are the funds being used for? *

Vendor Name (this could be the coach for a reimbursement) *

Vendor Phone #

Vendor Address where check is to be mailed. *

Mailing address *

mail to address provided

I have emailed an invoice with a clickable link to pay online (must be a completed invoice not a cart of items to be ordered)

Required

Shipping address for items to be shipped to CANNOT BE SCHOOL, orders with school address will not be processed. If picking up, please just type picking up. *

Amount to be paid *

Coach's Initials: By initialing this form I understand that anything purchased or ordered is my financial responsibility if I do not provide a receipt/invoice or if I do not have the sufficient funds available in my WAB account. *

A copy of your responses will be emailed to the address you provided.

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