EmailMeForm
Payment Request & Authorization
Immanuel Church-on-the-Hill
Date Submitted:
MM
/
DD
/
YYYY
Person Making the Request:
First
Last
Person Authorizing the Request:
First
Last
Amount Requested
*
$
Dollars
.
Cents
Budget Area
*
Please select
Building Maintenance & Repairs
Flowers
Grounds
Hospitality
Other (please specify below)
Purpose of Expense
File Upload
Please scan a PDF of the receipt or invoice associated with this expense and include it with this form.
Payment Information
Payee
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
