Kaleidoscope PTO Reimbursement Request Form
Fill form out completely within 60 days of your purchase and email kaleidoscopepto@ksk8.com with any questions
Submitted by
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First Name
Last Name
E-mail
*
Date
*
/
Month
/
Day
Year
Date
Expense Category
*
Please Select
Office Supplies
Art Supplies
Food
Special Event
Merchandise
Other
Expense Description
*
Amount
*
Please enter a number without a dollar sign.
Take a Photo of Your Receipt (Usually for a Smartphone)
Upload a File with Your Receipt (Usually for a PC)
Upload a File
Cancel
of
Signature
*
Type of Reimbursement
*
Paper Check
Submit
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