ATHLETICS AND ACTIVITIES PAYMENT REQUEST FORM

VENDOR INFORMATION Note - Process of Payment Could Take Up to 35 Days

Have you provided services to Edina Public Schools within the last 2 years and do you have a W9 on file? If you have moved or changed names within the last 12 months, please check "NO." *

Yes

I don't know

Please fill out and attach a W9 form. A W9 form can be downloaded and printed from this website: www.irs.gov/pub/irs-pdf/fw9.pdf

Please attach a completed W9 below or email to accounts.payable@edinaschools.org.

A current form must be on file prior to payment processing.

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone

Alternate Phone

Email Address *

Activity Information (Max 3 per Form)

Sport or Activity Name *

Level (Varsity, JV, B, or 9th) *

Activity Date * +

# Games *

Fee

Gender (Boys or Girls) *

Name of Opponent Playing Edina *

VARSITY Officials - Are you MSHSL Certified? (yes or no)

Sport or Activity Name

Level

Activity Date +

# Games

Fee

Sport or Activity Name

Level

Activity Date +

# Games

Fee

$0.00

Current Total:

Payment Authorization

By signing below I certify no part of the above request has been paid previously and that I have accurately recorded the services provided. *

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ATHLETICS AND ACTIVITIES PAYMENT REQUEST FORM

VENDOR INFORMATION *Note - Process of Payment Could Take Up to 35 Days*

Activity Information (Max 3 per Form)

Payment Authorization

VENDOR INFORMATION Note - Process of Payment Could Take Up to 35 Days