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Lincoln Avenue PTA Income Form
Instructions
* Please complete all items on the form below to submit income from PTA Events/Fundraising.
* Once you complete the form, contact
JSara Dworkin
to coordinate drop-off.
* Questions? Contact JSara Dworkin
jsaradworkin@gmail.com
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* Indicates required question
Requester Name:
*
Your answer
Requester Phone Number
*
Your answer
Requester Email Address
*
Your answer
Committee Name/Budget Line
*
Your answer
Committee Chair
*
Your answer
Description of Income
*
Your answer
Income Type (Select all that apply)
*
Cash
Checks
Direct Deposit
Required
Cash Only: Total Income from Cash
Your answer
Check Only: Total Income from Checks
Your answer
Direct Deposit Only: Total Income from Deposit
Your answer
Direct Deposit Only:
Please indicate vendor
providing direct
deposit (e.g. Cheddar
Up, Amazon Smile,
etc.)
Your answer
Please indicate how
you will be submitting
income. When
submitting physical income,
please include your
name and the
committee
name/budget line on
the envelope.
*
Direct Deposit
Send through Lincoln to Zachary Dworkin in 4D
Dropoff to JSara Dworkin at 3 Harding Street, PR
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