Request to Withdraw Funds
This form is for record keeping of a request to withdraw funds for Athletics from either site;  Middletown Middle School or Middletown High School.  Requests to "withdraw" funds to pay invoices for items covered in your fundraising efforts will be made by filling this form out completely, adding as much information as you can.  If you have additional information you need to add, send that information to :  mysportsboosters@gmail.com

Once the data is collected and reviewed by the Board will bring your items before the Board as a whole and vote on payment to be made on your behalf, using those funds raised for this event, item, or need for your team/student athletes.

Requests must be made no less than 7 days prior to a Boosters Meeting Date.  Agendas are posted for the public to review and weigh in on, and we must be diligent in providing our public the proper information needed.  In addition, your Sports Boosters Board is a volunteer position, and giving your Board Members the time necessary to present your item to the fullest is what our goal is.  Thank you for your consideration.

Thank you,
Middletown Sports Boosters
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Email *
What is the name of the payee: *
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Name of Person Making Request *
Phone Number: *
Fundraising for? **Please include sport, item, and needs you're requiring funds to be raised for: *
What is your role? *
Have you been in contact with a Board Member?  If so, who? *
Amount you want to distribute? *
Do you have an invoice for this/these items?
If you do, please provide the Middletown Sports Boosters Club with a copy of this invoice.  Invoice MUST be Billed to:  Middletown Sports Boosters Club

You may email a copy of the invoice to any of the following:  
mysportsboosters@gmail.com
tr.middletownsportsboosters@gmail.com
middletownsportsboosters@gmail.com
 *
Due Date of Invoice: *
Can this item be paid for by MSBC? *
Are you willing to attend the Middletown Sports Boosters Meeting where your item will be discussed? *
Required
Is this item covered by another entity? *
Will you need any remaining funds in this account for this same fundraising plan? * I do not want these funds to go into the 'general' basketball account yet.
Example:  Basketball raised $1000 and they spent $800; the remaining $200 will be distributed towards equipment in one month. 
 *
After the plan for payment has been made for said funds included in this fundraiser: Do you agree that the funds will go back into your earmarked fund for future use for the team.  Example: Basketball is Raised $1000 for equipment.  They spent $800; remaining $200 will go into Basketball's account for future use. *
Required
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