Invoice Request – Samaritans Feet

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Invoice Request

Your Name

Today's Date

Individual or Organization To Be Invoiced

Individual or Organization Name

Mailing Address

Suite

PO Box

City

Zip Code

Organization Primary Contact

First Name

Last Name

Phone Number(###) ###-####

Invoice Information

Responsible PartyWho will pay the invoice?

PO Number

Date of Invoice

Total Amount

Please complete the chart below the event(s) that this invoice will cover. Press "tab" to navigate between columns and to add additional events, click the "Add Another Event" button.

Events

Event ID	City, ST	# to Serve	$ Per Recipient	$ Amount	Event Type (see list below)
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(1)

Event Type Options: Back to School, Barefoot Golf Invitational, Champions of Hope, COVID, Gala, International Shoes of Hope, Final Four, Missions, National Day of Service, Shoes of Hope, Undesignated Funds, Warehouse, Other

Additional Comments

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