Remote Meeting Software Reimbursement

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Confirmation Number ID

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Instructions

Remibursements will be made for three (3) months of video conferencing service. To ensure that we are able to quickly and accurately process your reimbursement request please be sure to have the invoice for your first month of service ready to upload to verify purchase.

Accepted File Formats

pdf, doc, docx, xls, csv, txt, rtf, html, jpg, jpeg, png, gif

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Submitted by* This field is required.

First Name

Last Name

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E-mail* This field is required.Your email address

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League Name* This field is required.The name of your League

LWV of

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League ID* This field is required.The 5 digit ID for your League

US000

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Request Date* This field is required.

Date

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Reimbursement Amount* This field is required.The amount you are requesting for reimbursement

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Are you upgrading or purchasing new software?* This field is required.

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How will you be using this software?* This field is required.Board meetings, member meetings, public forums, etc.

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Upload Supporting Documents* This field is required.Please attach a copy of your receipt for one month of service. Reimbursement will be for three months of service.

Drag and drop files here

Select files to upload

Max. file size: 20.0MB

pdf, doc, docx, xls, csv, txt, rtf, html, jpg, jpeg, png, gif

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Direct Deposit Details* This field is required.Please indicate your direct deposit status. If you have received a grant from LWVUS in the past year your League is likely already setup for direct deposit. Note that this does not apply to payments or grants received from the Education Fund.

Already setup for direct deposit

Please use the details from our most recent PMP check to setup direct deposit

Would like to schedule a time to setup direct deposit over the phone

Unsure of direct deposit status

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Please verify that you are human* This field is required.