Receipt Submission
Name
First Name
Last Name
Email
*
example@example.com
Total Receipts to Submit
Please Select
1
2
3
Total Reimbursable Receipts
Please Select
0
1
2
3
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Receipt 1
R1 - Method of Payment
Paid with Live Oak CC
To Reimburse
R1 - Date of Purchase
-
Month
-
Day
Year
Date
R1 - Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
R1 - Description
R1 - Expense Category
Please Select
Bible
Language
Writing/Grammar
History
Science
Literature
Preschool
R1 - Lower or Upper School
Please Select
Lower School (PK-5)
Upper School (6-11)
Receipt 2
R2 - Method of Payment
Paid with Live Oak CC
To Reimburse
R2 - Date of Purchase
-
Month
-
Day
Year
Date
R2 - Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
R2 - Description
R2 - Expense Category
Please Select
Bible
Language
Writing/Grammar
History
Science
Literature
Preschool
R2 - Lower or Upper School
Please Select
Lower School (PK-5)
Upper School (6-11)
Receipt 3
R3 - Method of Payment
Paid with Live Oak CC
To Reimburse
R3 - Date of Purchase
-
Month
-
Day
Year
Date
R3 Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
R3 - Description
R3 - Expense Category
Please Select
Bible
Language
Writing/Grammar
History
Science
Literature
Preschool
R3 - Lower or Upper School
Please Select
Lower School (PK-5)
Upper School (6-11)
Submit
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