Expense Reimbursement Request

Expense Reimbursement Request
Payment Info
Delivery Method*
Have you submitted your ACH information to the Administrative Office?*

YesNo
Contact Info
Name*
Company Name or Individual's First & Last
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Request 1
1 - Ministry/Cost Center *
1 - Administration*
Expense Type
1 - Buildings & Grounds*
Expense Type
1 - Campus*
Expense Type
1 - Children's Ministry*
Expense Type
1 - Congregational*
Expense Type
1 - Creative Arts*
Expense Type
1 - Mature Adults*
Expense Type
1 - Missions*
Expense Type
1 - Singles/Young Marrieds*
Expense Type
1 - Sports*
Expense Type
1 - Young Families*
Expense Type
1 - Youth & Family*
Expense Type
Event Details
1 - What was business/ministry purpose of the expense?*
Describe what was paid for and the business/ministry purpose for the expense.
1 - Date of Event*

MonthDayYear
1 - People in Attendance?*
List all names (first and last), one name per line. If more than 12 people, just put the number of people in attendance.
Purchase Info
1 - Expense Amount*
1 - Where was the item purchased?*
1 - Date of Purchase*

MonthDayYear
1 - Receipt?*
1 - Provide Explanation:*
1 - Attach Receipt*

Cancelof
Add another request?

NoYes