Payment Voucher
Baseball
Basketball
Football
Soccer
Softball
Volleyball
Wrestling
Brevard
Flagler
Indian River
Lake
Martin
Okeechobee
Orange
Osceola
Palm Beach
Polk
St. Lucie
Volusia
(manual write-in)
County Schools
Astronaut High
Bayside High
Brevard Christian
Central Middle
Clearlake Middle
Cocoa High
Cocoa Beach High
Community Christian
Covenant Christian
Delaura Middle
Eau Gallie High
Edgewood Middle
Florida Air Academy
Holy Trinity
Hoover Middle
Jackson Middle
Jefferson Middle
Johnson Middle
Kennedy Middle
Madison Middle
McNair Middle
Melbourne High
Melbourne C.C. High
Merritt Island High
Merritt Island Christian
Palm Bay Baptist
Palm Bay High
Rockledge High
Roosevelt Middle
Satellite Beach High
Sebastian River High
Southwest Middle
Space Coast Middle
Stone Middle
Temple Christian
Titusville High
Victory Christian
West Shore Middle
(manual write-in)
School
Florida
The following information is required for payment to individuals who are not paid through the Payroll Department.
These payments will be reported to the Internal Revenue Service on Form 1099 on December 31st of each year.
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S.S. Number
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Zip Code
I have performed services for
Astronaut High
Bayside High
Brevard Christian
Central Middle
Clearlake Middle
Cocoa High
Cocoa Beach High
Community Christian
Covenant Christian
Delaura Middle
Eau Gallie High
Edgewood Middle
Florida Air Academy
Holy Trinity
Hoover Middle
Jackson Middle
Jefferson Middle
Johnson Middle
Kennedy Middle
Madison Middle
McNair Middle
Melbourne High
Melbourne C.C. High
Merritt Island High
Merritt Island Christian
Palm Bay Baptist
Palm Bay High
Rockledge High
Roosevelt Middle
Satellite Beach High
Sebastian River High
Southwest Middle
Space Coast Middle
Stone Middle
Temple Christian
Titusville High
Victory Christian
West Shore Middle
(manual write-in)
School on
January
February
March
April
May
June
July
August
September
October
November
December
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
2006
2007
2008
2009
2010
In the sport of
Boys Baseball - Varsity
Boys Baseball - Junior Varsity
Boys Basketball - Varsity
Boys Basketball - Junior Varsity
Boys Basketball - Sub Varsity
Boys Football - Varsity
Boys Football - Junior Varsity
Boys Football - Sub Varsity
Boys Soccer - Varsity
Boys Soccer - Junior Varsity
Boys Soccer - Sub Varsity
Boys Wrestling - Varsity
Boys Wrestling - Junior Varsity
Boys Wrestling - Sub Varsity
Girls Basketball - Varsity
Girls Basketball - Junior Varsity
Girls Basketball - Sub Varsity
Girls Soccer - Varsity
Girls Soccer - Junior Varsity
Girls Soccer - Sub Varsity
Girls Softball - Varsity
Girls Softball - Junior Varsity
Girls Softball - Sub Varsity
Girls Volleyball - Varsity
Girls Volleyball - Junior Varsity
Girls Volleyball - Sub Varsity
Game Fee $
Travel Allowance $
or