FCLIR Zoom Expense Reimbursement

FCLIR Zoom Expense Reimbursement

2020-2021 REQUEST FORM
Today's date*

MonthDay Year
Date
Your name*

First Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

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

Area Code Phone Number
Zoom use schedule*

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

Seminar host ($60 for 4 months per semester)Program host ($60/ 10 months of calendar year)FCLIR Council host ($150 for 10 months of calendar year)FCLIR Committee host ($150 for 10 months of calendar year)
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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