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Payment Authorization Form


Expense Category (check one)
_______Eckerd Living Center Gardens
_______Highlands School Garden
_______Old Jail House Garden
_______Community Support
_______Plant Sale
_______Miscellaneous Expenses
(Member Care, Membership, Publicity, Nurse Apprec)    
_______Operational Expenses
(Supplies, Website/Email, Address Book)

Submit this form by mail or email with receipts (scanned receipts sent by email are
acceptable) within two weeks of purchase.
For program fees, scholarship checks, and other expenses that do not involve receipts, simply submit this form.
Budget adjustments for expenditures exceeding committee/project budgets of $200 or less will only need Executive Committee approval.
Any expense more than $200.00 over budget must be approved by the Executive Committee and presented to the membership for advisement and voted on at the next meeting.

Reason for expense: _____________________________________

Date: __________________ Submitted: ___________________________

Total amount: $___________

Make check payable to: ________________________________________________

Did you send a copy to the Chair of the Committee or Project? Yes: _______

Submit form & receipts to Committee Chairperson

Approved by: ____________________________________________________________
(Committee Chairperson or member of the Executive Committee)
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