Online Check/Reimbursement Request Form Date* Date Format: MM slash DD slash YYYY Your Name* First Last Your Email* Charge Expense to this Committee*Select OneAngel FundBack to School DayClassroom Supplies - TeacherClassroom Supplies/Support - 6thClassroom Supplies/Support - 7thClassroom Supplies/Support - 8thClasssroom Supplies-EncoresCommunity ServiceContingencyDirectory ExpenseDist 181 FoundationEagle Clubs & ActivitiesEagle Fund (Principal's)Eagle MusicalsEvents FundGraduation ExpenseHospitalityInsurance/Audit/FinancialsLandscapingMedia Center SupportPTO OperatingSpirit ClubStaff AppreciationStrategic PlanningTechnologyWelcome Committee/6th Grade SocialOther (please indicate in note section)Description of Expense*Please indicate if the check is needed by a certain date. Date Format: MM slash DD slash YYYY Make Check Payable to:*Check Amount*Mail Check to:Note: For teacher reimbursements, please use CHMS address: 301 Chicago Avenue. If the check needs to be delivered or brought to an event, please indicate in the "Note" section below. Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Scan or photograph receipts/invoice and attach electronically here.*We cannot process payment without appropriate documentation. Accepted file types: jpg, gif, png, pdf. If you take a photo, please make sure the files size is not too large. Drop files here or Accepted file types: jpg, jpeg, pdf, png, gif. Please put any notes to Treasurer here:PLEASE NOTE: For reimbursement, please submit expenses within 30 days of the event to the Treasurer. Please be sure to use the CHMS PTO tax exempt letter for all purchases. EmailThis field is for validation purposes and should be left unchanged.