Custom Fit Reimbursement Form

Reimbursement Form
Company Information: Please fill out completely to avoid delays with reimbursement
Company Name:
Mailing Address:
City: State: Zip Code:
City:
State:
Zip Code:
Contact Name:
Position:
Phone #:
Cell #:
Contact Email:
example@example.com
Course Information: (Must be submitted to Custom Fit prior to start of class)
Name of Course:
Training Company Name:
Company website with course information preferred
Cost per Person:
Start Date of Course:

MonthDayYear
Date
Employee Information: (List additional employees on a separate page)
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
*This is required for reporting to the Utah System of Technical Colleges and will not be shared with any other organization or business.
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Disclaimer: Employee information will be used for internal purposes only and will not be sold.
Upload the following documentation:

Invoice and proof of payment (include for any books required for course)

Proof of completion of course (roll, certificate)
Browse Files

Cancelof
Questions?

Lezlee Whiting | Custom Fit Senior Officer | Uintah Basin Technical College

Office: (435) 725-7109

Email: lezlee@ubtech.edu

Lisa Labrum

Custom Fit Administrative Assistant

Office: 435.725.7124

lisal@ubtech.edu

Kimberli Wadsworth

Administrative Assistant Energy Services

Office: 435.725.7110

kimberliw@ubtech.edu
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