Leman PTO Expense Reimbursement Request
Please submit any expenses that you wish to reimbursed for, include a description and copy of your receipts.
Submitted by
*
First Name
Last Name
E-mail
*
Date
*
/
Month
/
Day
Year
Date
Expense Category
*
Please Select
Classroom Stipend
Event
Fun Run
Grant (Science, etc.)
House Event
Staff Appreciation
Office/Meeting Supplies
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
*
Address (only provide if you need your check mailed)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: