WELLWOOD YACHT CLUB

Check Request/Payment Approval Form

Make check payable to (type or print name): _________________________________________________________________________

Address:_______________________________________________________________________________________________________

Phone: _______________________________________________________________________________________________________

Description/Purpose: ____________________________________________________________________________________________

_____________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

Amount:___________________________

Special Instruction for Delivery: _____________________________________________________________________________________________________________

Requested by (Print name) ___________________________  Signature:___________________________    Date__________________

Approved by (Print name) _______________________  Signature:___________________________   Date__________________

ORIGINAL RECEIPTS AND INVOICES MUST ACCOMPANY EACH CHECK REQUEST

Date Received: _______________________                   Treasurer's Initials: _________________

Date Paid ___________ Check number: ______ Amount: ______________________

Home | Webmaster