ROSSMOOR MEN’S GOLF CLUB

1010 Stanley Dollar Drive

Walnut Creek, CA 94595
(925) 933-2607

Attention Treasurer:
Subject: Request for Check Disbursement for Club Expenses or Inventory

Date: ______________________

Make check Payable to : ________________________

Amount : _______________________

Explanation of Expense: __________________________________________

Rossmoor Men’s Golf Club Event: ________________________________

Vendor: _______________________________________________

Attach Receipts or give details of expense

I attest that the foregoing is an accurate expense of the Club within the scope
of my assignment to authorize

Print Name: ________________________________

Signature: __________________________________ Date:______________

Approved by: _______________________________ Date:______________