Purchase Form

Name

First Name

Last Name

Phone Number & Email

Checkbox

Please indicate if this is a reimbursement of purchase or a request for money before purchase.

Reimbursement (Purchase already made with my own money)

Request (Purchase will be made with this money)

Ministry

Please Describe Ministry Need:

Amount Requested:

STAFF USE ONLY:

Approved By: __________________________________________ Signature: ____________________________________________

ONCE THIS PURCHASE FORM IS SUBMITTED, YOU WILL BE IN CONTACT BY AN EAST VALLEY STAFF MEMBER AFTER APPROVAL AND FOR FURTHER INSTRUCTION