PTSA Disbursement Form Instructions

Please follow the below instructions to ensure your disbursement request is processed in a timely manner.

How to complete the form

  1. Print a disbursement form.
  2. Fill in the date of submission where indicated.
  3. Request number: this is the Initials of the first and last name of the person requesting the reimbursement and the six digit date representation. (Example: JD083114) This will make it easier to refer back to the correct disbursement if there are any questions.
  4. Pay to the order of: please fill in the name of the person the reimbursement check will be paid to as it should appear on the check.
  5. Address: please write the address where the check should be sent.
  6. Amount: fill in the dollar amount in text as it would appear on the check followed by the cents and then the numerical amount next to the dollar sign.
  7. Charge to the account of: write which account this payment would be applied to. This is very important as the payment gets applied against the budgeted amount for that item which is prepared at the beginning of each year. (Examples: SAT, P3, Film Fest, Staff appreciation, School, Membership, etc.)
  8. Purpose: please indicate the sub account or the nature of the expense. (Examples: Decorations, staff lunch, senior breakfast, entertainment, etc.)
  9. Itemized Expenses: please indicate the specific amounts that are being applied to this disbursement. For one receipt, please use values like 'food' and 'decorations'. If multiple receipts are being submitted, please indicate the store or company and the general item type purchased. (Example: Target – food, Party City – decorations, etc.) When submitting multiple receipts, it is helpful to number them so that the amounts are easier to locate and double check.
  10. Total: add up the itemized expenses. This amount should match the amount written above.
  11. Please print and sign the name of the person requesting the disbursement as well as provide your contact phone number and email address in case there are any questions.

How to submit completed form

  1. Email the completed disbursement request form and copies of the receipts to the treasurer’s email address.
  2. Please place the disbursement request in the mailbox at the school. Make sure to keep a reference copy of all disbursement request forms and receipts with you. If this is an urgent request and you are unable to email the form, please call or email the treasurer so that arrangements can be made to pick up the request.

Fulfillment Process

  1. Once the disbursement check is received, it takes approximately 7-10 business days to fulfill the request depending on the availabilities of those responsible for signing the checks. The disbursement checks require two signatures to be honored by the bank and therefore the fulfillment of the requests is subject to the availability of the signatories.
  2. If a disbursement is time sensitive, contact the treasurer so that it can be processed by the deadline.
  3. Please make sure all fields on the disbursement form and all receipts are submitted in order to ensure the request is fulfilled in a timely matter. Incomplete requests will delay the fulfillment process.

If you have any questions or concerns, please contact the treasurer at