RHS Drama Boosters Reimbursement Request

Reimbursement Request
Use this form to request reimbursement for an an approved, prepaid expense. If you are requesting a check to pay for something, use the Check Request Form.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Describe the purpose of the expense (what was it for):
Expense relates to

Other
Date on the receipt

MonthDayYear
Date
Original Payment was made to (vendor name on the receipt):
Amount to be reimbursed
Upload image(s) of the receipt.

Be sure each item and the total are readable.
Cancelof
Or take a photo of the receipt now.
Reimbursement Options (payments now made via ACH)
Include reimbursement notes here:
Please confirm:
Signature
Should be Empty: