BSCO Check Request Form

All requests must be supported by original receipts or invoices and submitted within 30 days of the incurred expense. After submitting this form, please email photos of the supporting receipts/invoices (in one email) to receipts@bonnyslopebsco.org. Include your full name in the email. Checks will be mailed to the address below approximately two weeks after receiving this form and the supporting receipts/invoices.

Check Payable To

Amount

Payee Address

If request is to pay an invoice (e.g., OMSI, Artist in Residence, Party Vendor) please find address on invoice and write, here.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Committee/Event

Class Party for Winter and Valentine's Party. For Class Party, please enter the Grade below. For Other, please fill in below.

Other/Grade

Explanation

Please provide a brief explanation of the invoice or receipt request.

Other Information

Your Name

First Name

Last Name

Your Phone Number

(###)

###

####

Your Email Address

By clicking on the ‘Submit’ button, I certify that: 1. All submitted expenses are BSCO-related, accurate and comply with BSCO reimbursement policies. 2. I have not received, nor will I receive, reimbursement from any other source(s) for the expenses claimed. 3. In the event of overpayment, I assume responsibility for repaying BSCO in full for those expenses.

Remember to submit your receipts to the new address: receipts@bonnyslopebsco.org. Include your full name in the email so we can match it to your request.