Teacher Payment Report

Teacher Payment Report

Chapters should submit this report to the AQG Treasurer of monies paid to a Teacher/Speaker
Date of Form *

Month Day Year
Date
Chapter *
Chapter Contact *

First Name Last Name
Chapter Contact Phone Number *

Area Code Phone Number
Chapter Contact Email *
example@example.com

Teacher/Speaker Information

Please provide as much information as possible about the Teacher/Speaker and the date of your event.
Date of Class/Lecture *

Month Day Year
Use first date if engaged for multiple days
Name of Class/Lecture
Speaker/Teacher Name *

First Name Last Name
Teacher Email
example@example.com
Teacher Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Teacher Phone Number

Area Code Phone Number
Upload a copy of Teacher W9 form

Browse Your Own Files
PDF scans and all photo formats accepted Cancel of
Amount paid for teaching/speaking fees *
Amount reimbursed for travel or supplies
Total paid to Teacher:
Calculated for you
Comments or Notes for the AQG Treasurer
(Box will expand as you type)
What happens next?
1. Please print a copy of this report for your records (right button below) before you submit (left button below).
2. You should recieve an automatic email confirmation very soon after you submit the report.
3. The AQG Treasurer will follow up with you if she has any questions.
Thank you for taking time to fill out the Teachers Payment Report
Should be Empty:

Teacher/Speaker Information