KCYC Event Reimbursement Form
Event Date
*
-
Month
-
Day
Year
Date
Event Name
*
Hosted By
*
Short Description of the Event
Total estimated Revenue
Post Event Actual Revenue:
rate per
actual number sold
Total
Member rate
Guest rate
Total actual Revenue
Expenses incurred:
description
purchased at
total amount
1
2
3
4
5
6
7
8
Total expenses submitted for reimbursement
Actual Revenue - Expenses submitted
Please attach receipts
Browse Files
Cancel
of
Please email copies of receipts separately
Please send receipts to kcycsocial@gmail.com
Who is getting reimbursed? (usually just the person submitting this report). The total of these must equal the total expenses submitted above.
Request Check Payable to:
mail to address on file? Or?
total check requested
1
2
3
4
Total Checks requested for reimbursement:
Total Expenses submitted - Total Checks requested (needs to be ZERO)
Report submitted by:
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
For KCYC Treasurer use only:
Treasurer only to fill in:
Approved
Receipts received and verified
Check number
Save
Submit
Should be Empty: