Elkhorn Public Schools

Elkhorn High School Band Department

Dear EHS Band Booster Treasurer, I, _________________ would like to request that
Print students name

the following amount ________ be taken from my band account to pay for ________________.
(please list- band camp fee, band bill, trip payment, etc.)

Sincerely, ___________________ ____________

Student Signature Date

___________________ _____________
Parent Signature Date

*Please turn this form in to the collection box in the band room*
Treasurer use only: Funds applied to specified purpose in the amount of _____ on _______(date). __________________