Peebles Elementary School

         Parent Request for PTA Funds

Name: _______________________________________  Date: _____________________

Phone Number: ________________________________

Description of event, project, need: ______________________________________________________

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Amount Requested (receipt attached): _________________________________________

Please select one of the following:

_________Send payment with my child, Name _____________________, Homeroom_______________

_________I will pickup from the PTA mailbox.

_________Please mail the check to my home address.  _____________________________________

                                                                                     _____________________________________

                                                                                     _____________________________________

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PTA Action:  Granted _______ Refused _______

Treasurer’s Signature _____________________________________

*Requests for Refunds are due within one month of the event*

After May 1^st, requests are due by the end of the school year