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Application Nameorbeon Form Namepta-payment-authorization Form TitleOrbeon Demo: PTA Payment Authorization/Request for Reimbursement Form Description<div>This demo forms shows:</div> <div> <ul><li>the use of a PDF template</li><li>setting checkboxes in a PDF template</li><li>handwritten signatures</li><li>the use of the Multiple Attachments form control</li><li>a closed-by-default section, which could be entirely hidden if you add permissions to this form</li></ul> </div> /fr/service/persistence/crud/orbeon/builder/data/8fcdfe4ff49218923b6599ec9c7bb91488fcdf1a/9337d06aa456ea8ffa32b35544e56a084eab0f94.bin { "inline" : true, "hidden_input" : false, "language" : "en", "statusbar" : false, "menubar" : false, "plugins" : "lists link", "toolbar" : "bold italic | bullist numlist outdent indent | link", "browser_spellcheck" : true, "encoding" : "xml", "entity_encoding" : "raw", "forced_root_block" : "div", "visual_table_class" : "fr-tinymce-table", "skin" : false, "convert_urls" : false, "sandbox_iframes" : true, "convert_unsafe_embeds": true }

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SchoolMissing or incorrect value

Treasurer email addressMissing or incorrect valueAn email will be sent to the organization's treasurer

Name of PayeeMissing or incorrect value

PTA PositionMissing or incorrect value

AddressMissing or incorrect value

CityMissing or incorrect value

Zip Missing or incorrect value

Phone

EmailMissing or incorrect valueAn email will be sent to the payee

Expenditure was forMissing or incorrect value

Expenditure Description

Expenditure Amount

Expenditure DescriptionMissing or incorrect value

Expenditure Amount Missing or incorrect value

Total Expense

Total Amount Claimed Missing or incorrect value

Minus Advance Received

Reimbursement Claimed

Not Claimed - donate to PTA

Refund to PTA (Enclose Check)

Attachments/receipts

Drag files here or select files.

Signature

Missing or incorrect value

Signature of VP/Chairman for Program/Event

Date Missing or incorrect value

Mark this checkbox if you'd like to type HTML tags Click to enter a label Type your label here Click to add a hint Type your hint here Click to enter text Type your text here

Click to enter a section title Type your section title

Form Builder

Orbeon Demo: PTA Payment Authorization/Request for Reimbursement

School

Payee

Expenditure

For PTA Treasurer Use