RCS Reimbursement/Check Request Form
Person Completing Reimbursement Request:
*
First Name
Last Name
Who is the approving administrator?:
*
For Principals or DO Staff - Dr. Hearne
Curriculum - Dr. Hearne
MS - Dr. Castaneda
HS - Mr. Redemer
RCE - Miss Sinisi
Transportation - Mr. Huemoeller
EC - Mr. Lee
IT Infrastructure- Mr. Hearne
Athletics - Mr. Babinat
Submitter's Email:
*
example@example.com
Is the check for an Individual or Business Entity?:
*
Individual
Business Entity
Payroll (for stipends only)
Make Check Payable To:
*
First Name
Last Name
Business Name:
*
Deliver To:
*
District Office
Elementary
MSHS
Check To Be Mailed
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Purpose of Reimbursement Check:
*
Upload Receipts:
*
Browse Files
PDFs Strongly Preferred Over Image Files
Cancel
of
Amount:
*
Breakdown of Amount Requested
*
Sport
*
Sport Level
*
Please Select
High School
Middle School
Submit
Should be Empty: