Fort Mill Band

Purchase Order Payment

PO Payment Request

Name(Required)

First Last

Email(Required)

School(Required)

Payment Information

PO #

Amount Due(Required)

Receipt Submission(Required)

Email

Deposit Box

Postal Mail

Due Date

Unspecified

ASAP

Other

Vendor Information

Vendor Name

Vendor Phone

Vendor Email

Vendor Address

Street Address Address Line 2 City State ZIP Code

Purchase Items

Item #1 Description

Item #1 Cost

Item #2 Description

Item #2 Cost

Item #3 Description

Item #3 Cost

Notes

Email

This field is for validation purposes and should be left unchanged.