Check Request Form - Soroptimist International of Lakeview

Indicate type of expense:

Make check to_____________ and amount_______________.

Address

Address Line 1

Address Line 2

City

State

Zip Code

Expense detail (include committee/event and item) (i.e.: Oktoberfest decorations)

Requested by______________ Date_______________

Check box if payment is to be mailed directly to requestor

Return completed form to treasurer at the address below or call Judy @541-417-0476

Judy Graham, P.O. Box 464, Lakeview, OR 97630

Complete by treasurer – check # and date