FCLIR Zoom Expense Reimbursement

FCLIR Zoom Expense Reimbursement
Today's date*

MonthDayYear
Date
Your name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number

Area CodePhone Number
Zoom use schedule*

Fall semester, 4 monthsSpring semester, 4 monthsMonthly meeting, 10 monthsOther
Zoom use category*

Seminar host ($68 for 4 months per semester)Program host ($170// 10 months of calendar year)FCLIR Council host ($170/for 10 months of calendar year)FCLIR Committee host ($170/for 10 months of calendar year)Other
Upload your expense receipt

Browse Files
receipt required for all expense reimbursement requests Cancelof
Note:
Reimbursement checks will be mailed from Five Colleges, Inc., and may take up to 2 weeks to be issued.
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