PLRF Request Form

PLRF Vendor Request Form

"*" indicates required fields

Use this form when submitting a mentor invoice.

Activity Start Date*

Teacher's Name*

First Last

Teacher's Email*

You're receive an auto-confirmation at this address

Purpose of invoice or receipt (what were the funds used for)*

This field is hidden when viewing the form

Is this vendor registered with the school district?

Yes, they're on file

No, they're not on file

Unsure

Vendor Name:*

Vendor's Email Address:*

Invoice Amount:*

Please upload image(s) of the invoice - multiple files can be uploaded:*

Drop files here or

Max. file size: 40 MB, Max. files: 10.

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