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[]
[]
["Potomac Station Sailfish"]
[]
["Check Request"]
[]
["DATE:",null,null,null,null,null,"AMOUNT:","$"]
[]
["PAY TO:"]
[]
["ADDRESS:"]
[]
["CITY:",null,null,null,"STATE:","VA","ZIP:"]
[]
[]
["PURPOSE:",null,"$Amount",null,null,null,"$Amount"]
[null,"Concessions",null,null,null,"Patches/trophies/medals"]
[null,"Equipment puchase",null,null,null,"Registration supplies"]
[null,"End-of-season Party",null,null,null,"Ribbons"]
[null,"Ice cream ",null,null,null,"Spiritwear"]
[null,"Meet supplies",null,null,null,"Other"]
[]
["DESCRIPTION OF ITEMS PURCHASED:"]
[]
[]
[]
["Remember to attach appropriate receipts."]
[]
["REQUESTED BY:"]
[null,null,"Name"]
[]
[]
[null,null,"Signature"]
[]
[]
["REMARKS:",null,null,"TEAM CREDIT CARD USED - NO CHECK NEEDED"]
[null,null,null,"MAIL CHECK TO PAYEE"]
[null,null,null,"PICK UP CHECK"]
[null,null,null,"OTHER INSTRUCTIONS"]
[]
[]
["Treasurer- Ruth VanTuyle"]
["This completed form should be placed in reimbursement folder at swim team practice."]
["The reimbursement folder will be checked once pre week during the swim season."]