Check Disbursement Request

This form should be completed and submitted to request a check disbursement.  The completed form will be sent to the Finance Ministry.  

*** Key Reminders ***

  • All receipts must be provided prior to receiving a check.
  • Request with receipts submitted by 4:00pm on Thursday will be ready for pick-up the following Sunday.
  • A signature will be required when picking up the check.

Check Disbursement Request

Today's Date(Required)
This check request is for:(Required)

Date Needed(Required)
Enter name here if different from name listed above.
Enter a contact email address here if different from the email entered above. A copy of the check request will be sent to this email address.

Drop files here or
Accepted file types: jpg, gif, png, pdf, Maximum File Size is 1.5 GB.
    DO NOT upload credit card statements.