PTA Expense Reimbursement

INSTRUCTIONS

1. Use this form for miscellaneous receipts for reimbursement (not for check requests to pay a vendor who submits an invoice).

2. Please submit reimbursement requests within 60 days of purchase.

3. Make copies of the form and receipts for your records.

4. Multiple purchases: If your purchases exceed the lines provided, then either combine them or submit multiple forms.

5. Need help with this form? Contact the current PTA Treasurer: treasurer@beaconhillpta.org
Beacon Hill International School PTA

Reimbursement Request Form
What CATEGORY of expense did you incur? *
Teachers and Staff should choose Programs. If you are not sure, choose Programs.
Which PROGRAM was your expense for?
Which FUNDRAISING EXPENSE did you incur?
Which MANAGEMENT & ADMINISTRATION EXPENSE did you incur?
If Misc Category, please specify here:
PTA member/ staff/ teacher to be reimbursed *

First Name Last Name
Contact Number of person to be reimbursed *
Ex. 917 501 7365
Email of person to be reimbursed *
How would you like to receive your reimbursement?

Paper check, sent by USPS Mail Zelle PayPal
Mailing Address of person to be reimbursed

Street Address

Street Address Line 2

City State

Zip Code
If you selected Zelle, what is the email address or phone number linked to your Zelle account? *
If you selected PayPal, what is the email address linked to your PayPal account? *
ITEM 1
Item 1 Date of purchase *

Month Day Year
Date
Item 1 Amount $ *
Item 1 Vendor/ Source *
Item 1 Description *
Item1: UPLOAD photos of your receipt(s) *

Upload Photo
you can upload multiple images by hitting the upload button more than once Cancel of
ITEM 2
Item 2 Date of purchase

Month Day Year
Date
Item 2 Amount $
Item 2 Vendor/ Source
Item 2 Description
Item 2 : UPLOAD photos of your receipt(s)

Upload Photo
you can upload multiple images by hitting the upload button more than once Cancel of
ITEM 3
Item 3 Date of purchase

Month Day Year
Date
Item 3 Amount $
Item 3 Vendor/ Source
Item 3 Description
Item 3 : UPLOAD photos of your receipt(s)

Upload Photo
you can upload multiple images by hitting the upload button more than once Cancel of
ITEM 4
Item 4 Date of purchase

Month Day Year
Date
Item 4 Amount $
Item 4 Vendor/ Source
Item 4 Description
Item 4 : UPLOAD photos of your receipt(s)

Upload Photo
you can upload multiple images by hitting the upload button more than once Cancel of
Total Amount
Thank you!

If you have any questions, contact the current PTA Treasurer: treasurer@beaconhillpta.org, President: president@beaconhillpta.org, and/or Vice President: vp@beaconhillpta.org.
Should be Empty:

Beacon Hill International School PTA