NOTE: Each receipt must be submitted separately.
* indicates required fields.
1. Name of Purchaser *
Purchaser's Phone (e.g. 650-555-1212) *
2. Purchase Date *
3. Purchase Amount *
4. Merchant Name *
5. Business Purpose (WHO, WHAT, WHY) *
6. Participants (if food-related) if none, please enter N/A *
9. Please provide employee ID number if STAP related *
10. STAP Fund Balance (please verify balance in Axess)
11. Amount of STAP Funds to be applied *
12. Upload Receipt ( 1 receipt per request) *
13. PTA ______________________Expenditure Type____________ [TO BE COMPLETED BY TONYA JACKSON]
14. Email address *
Please skip. Do not fill this out.