Check Request Form | Medina High School

Name of Person/Group requesting check: *

Pay to the Order of: *

Total amount to be paid: *

Sport/Team bucket paying for this: *

Date needed by: *

Month

Day

Year

Check Delivery Instruction: (Picked up by? Drop off location? Mailing Address?): *

Reason for Check: *

Approved/Acknowledged By: *

Invoice or Initial Request information must be included to support the expense.
No check will be cut without all this information and approval/acknowledgement.
Thank you.