SERVE Reimbursement Request
All reimbursement requests must be submitted within 14 days of purchase
Full Name:
*
First Name
Last Name
Email Address:
*
example@example.com
Contact Number:
*
Please enter a valid phone number.
Total Amount:
*
Expense amount pre-approved by SERVE Board or Events Coordinator:
*
Yes
No
Project / Category:
*
Please Select
EVENTS - Bingo Event
EVENTS - Daddy Daughter Night
EVENTS - Fall Carnival
EVENTS - Grandparents Day
EVENTS - Meet The Teacher Night
EVENTS - Merry Market
EVENTS - Mother Son Event
EVENTS - New Family Night
FUNDRAISING - Book Fair - Spring
FUNDRAISING - Box Tops for Education
FUNDRAISING - Candy Grams (Christmas)
FUNDRAISING - Chipotle Fundraiser
FUNDRAISING - Fry's Rewards
FUNDRAISING - Uniform Sales
NVCA Support - Hospitality - MS/HS Birthday Treat Days
NVCA Support - Hospitality - Teacher Appreciation
NVCA Support - Lion Card Expenses
NVCA Support - Promotions (Kinder + 8th Grade)
SERVE Support - Prayer Team
SERVE Support - SERVE Christmas Party
SERVE Support - SERVE Apparel
SERVE Support - SERVE Meetings
SERVE Support - SERVE Supplies/Assets
SERVE Support - SERVE Year-End Appreciation Party
Reason for reimbursement:
Please provide a brief summary of what was purchased
Please itemized list of receipts, include store name and amount spent (ex: Costco $45):
*
Store Name / Short Description of Purchase:
Amount:
1.
2.
3.
4.
5.
6.
Upload Your Receipts:
*
Browse Files
Drag and drop files here
Choose a file
If you have not retained your receipts, please contact Lisa for further instructions ( lisa.fernald@gmail.com )
Cancel
of
Full amount spent (partial reimbursements):
If you are only requesting a partial reimbursement, please include the full amount spent here for budgetary purposes only
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PAYEE INFORMATION:
Check Payable to:
*
First Name
Last Name
Payee Full Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
FOR INTERNAL USE ONLY
Accepted By:
Date:
Check Number:
Method:
Submit
Should be Empty: