Room Parent Reimbursement Request
Instructions and Notes
Reciepts
Reciepts need to include store name, date, amount and proof of payment
If you have personal items on the same receipt, please
CIRCLE
the items you want reimbursed and add a note of clarification in the comments section of this form
Taxes
If you have any personal expenses on a receipt, the Foundation will NOT reimburse any portion of taxes
Otherwise, taxes are fully reimbursed
Timing
Please allow up to 3 weeks to receive your check in the mail
If you do not receive a check within 3 weeks, please email Trista at
ptomb-assistanttreasurer@aak8.org
Name
*
First Name
Last Name
Email
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of Receipts
*
Grade Level
*
Please Select
N/A
KP - Roy/Watzke
KP - Ahn/Thompson
KP - Lagerstrom
KP - Emerson/Millar (2 days)
KP - Emerson/Millar (3 days)
KP - Mohr
K
1
2
3
4
5
Middle School
Total Amount Requested for Reimbursement
*
Description of Expenses
*
e.g., Fall party craft supplies, Ms. Marion’s birthday gift
Comments
Please add any notes for receipts with partial reimbursements or any additional comments
Receipt(s)
*
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