Payable to: (Send to:)

ATHLETIC DEPARTMENT FOUNDATION CHECK REQUEST From:

__________________________

Date:

__________________________

RE:

Check Request Pre Approval

Payable to: ______________________________________ (Send to:) _______________________________________ ______________________________________

FOR FOUNDATION USE ONLY Approved Date Initials

Reviewed Date Initials

______________________________________

Invoice Number: ________________________________

Amount:

$

_______________ Account Number Purpose of this

______________________________________________ Account Name

__________________________________________________________________

Request or check __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Fund/ Account Manager _____________________________________Date ______________________ Compliance _______________________________________________Date______________________ Senior Woman Administrator__________________________________Date _____________________ Senior Associate AD _______________________________________Date______________________ Athletic Director ____________________________________________Date______________________