FCLIR General Expense Reimbursement

FCLIR General Expense Reimbursement
If you are requesting reimbursement for the use of your Zoom account for FCLIR-related work (hosting a seminar, hosting committee meetings, etc.) please use THIS FORM.
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
Expense Date*

MonthDayYear
Date
Expense for*

Administrative/ OfficeCouncil / Exec CommCurriculum Committee (including Preview)Seminar expenses (Moderator only)Communications CommitteeProgram Coordination CommitteeTechnology (not incl Zoom)Other
Expense category(can be multiple items)*

Copying & printingPostageTravel & parkingEvent tickets/reservationsAdmission fees/ donationsFood & beverage (non-alcoholic)Beverage (alcoholic)SuppliesMinor EquipmentSpeaker fee/ HonorariumOther/not listed (describe below)
Expense Total:*
Expense Description:
Upload your expense receipt

Browse Files
receipt required for all expense reimbursement requests Cancelof
Note:
Include what committee or FCLIR officer authorised this expense, if not stated above
Reimbursement checks will be mailed from Five Colleges, Inc., and may take up to 2 weeks to be issued.
Should be Empty: