ALLENDALE WOMAN’S CLUB
DIRECT BILLING / DONATION FORM
Please attach this form for direct payment or donation with either a signature of receipt (see below) or vendor bill.
All direct billing/donations must be approved by Chair or Executive Board Member.
Date Submitted: ________________________________
Name: ________________________________________
DETAILS of Direct Payment or Donation:
Vendor/Donation Contact: __________________________________(non-club member)
Phone number of Contact: ___________________________________
Signature Receipt of Payment: X_________________________________________
Department/Event:________________________________________________
Brief Description: ________________________________________________________________________
________________________________________________________________________
Total Amount $________________________
Approved by: ________________________________ (Dept/Event Chair/Exec. Board)
For Treasurer:
Date Payment: _________________________ Check Number: __________________
Payee: __________________________________