Reimbursement Request

If you require a reimbursement, please fill out this form after speaking with a board member to get verbal authorization. We can not guarantee that you will be reimbursed if the funding is not authorized before monies are spent.

If you are looking to receive a grant for a future project that you are planning and want to request funding, you will find that form by clicking HERE

Date of Purchase

Your Name

Phone

We will only call if we have questions.

Vendor

Store name(s) or website(s) where items were purchased.

Item Description

Please give us a short description of the items purchased, including quantities.

Purpose or Use

Please tell us the name of the event, classroom, or project these items were purchased for.

Amount

Please tell us the total amount of the reimbursement expense. (amount of the check we will issue to you)

Payable To

Enter the name you want on the reimbursement check.

Authorization

Please list name of the individual who authorized your purchase.

Receipt

Please upload copies of your receipts.

Receipt

For additional receipts if needed.

Receipt

For additional receipts if needed. If you need to upload more than (3) receipts you may start another request after this submission

and mention in the Item Description box that it is a continuation of the original request.

You must check the small box confirming whether you are finished or not before the system will allow you to save/submit the form.