CLOTHING PURCHASED MONTHLY

THIS FORM IS TO BE RECEIVED IN THE OFFICE BY THE 10TH OF EACH MONTH

_____________________________________________ Childs Name

______________________ Month Year

DATE OF PURCHASE

LIST CLOTHING ITEMS PURCHASED

DOLLAR AMOUNT

TOTAL A MINIMUM OF $40.00 IS TO BE SPENT ON CLOTHING MONTHLY.

*ALL ORIGINAL RECIEPTS MUST BE ATTACHED TO THE BACK OF THIS FORM. *THE RECIEPT DATES MUST COINCIDE WITH THE MONTH FOR WHICH YOU ARE REPORTING.

BETH.FORMS.CLOTHING PURCHASED MONTHLY