PAYMENT/REIMBURSEMENT AUTHORIZATION FORM
STUDENT ORGANIZATIONS - HOUSES - ENTRIES
Check Payable To: (no nicknames)
Address:
Classification:
Wms Employee
Wms Student
Other
Payment Method:
Check
Direct Deposit
Special Handling:
Enclosure
Pickup
(Emergencies Only)
Account (6)
Fund (3)
Dept ID (7)
Today's Date
Amount-insert decimal
Event Name:
Event Date:
Item Description:
Account (6)
Fund (3)
Dept ID (7)
Today's Date
Amount-insert decimal
Event Name:
Event Date:
Item Description:
Account (6)
Fund (3)
Dept ID (7)
Today's Date
Amount-insert decimal
Event Name:
Event Date:
Item Description:
Student Organization/House/Entry: (requesting funds)
Finance Officer's Name
E-mail address:
Finance Officer's - Signature:________________________________________ Date:____________
***Office Use Only***
College Council - Authorization:________________________________________ Date:____________
Campus Life Office, Multicultural Center - Authorization:________________________ Date:_____________