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Memorial High School Theatre

Reimbursement Form

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Request for Check

MHS Theater Booster Club

 

 

Request Date             ___                     Approval Signature_____________

Request Amount                                  

 

Payee:                                                                                                

 

Address:                                                                                

                                                                                               

 

 

Itemization of Expenses

Description                                                                    Production            Expense Amt

 

                                                                                                                                               

                                                                                                                                               

                                                                                                                                               

                                                                                                                                               

 

 

Requested by:                                                              

 

Approved by:                                      

 

IMPORTANT:  Attach invoice or sales slip(s) to this form.

 

 

Reimbursement requests should be placed in theater lock box located in the theater black box room.  All origianl receipts must be attached to this form when submitted.

 

 

 

 

 

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Paid Date:                                                                    Check #: