Substitute Invoice Submission Form

Substitute Invoice Submission Form

Please complete this form ACCURATELY and COMPLETELY to request substitute reimbursement. If you have any questions, please contact GCEE's Associate Director, Chris Cannon at ccannon11@gsu.edu.
Name of person completing this form
Contact e-mail for questions about the submission
example@example.com
Phone number for questions related to this request
Title of the GCEE workshop attended
ex: March-2024
Date of workshop attended

MonthDayYear
Date
Location of workshop attended
Workshop leader
How do you want GCEE to reimburse your school/school system?
Who should check be made payable to?
Name/title of person and title check should be mailed/addressed to
Mailing Address for Check

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank Name for ACH
Routing Number for ACH - 9 digits
Account Number for ACH (PLEASE ENTER CAREFULLY)
How many teachers are you requesting reimbursement for? (Attendance at full workshop is required for reimbursement.)
Name of school(s) where these teachers work
Enter the names of the teachers that attended the workshop listed above.
What is your school/system's substitute rate PER DAY (the cost of one substitute)?
What is the TOTAL AMOUNT being requested on this submission?
Upload any documents if necessary (like a list of attending teachers).

Cancelof
School Acknowledgment:

By submitting this form, I certify that the information provided is accurate and that I am authorized to submit invoices on behalf of the school or school system.
Signature
Date Submitted

MonthDayYear
Date
Should be Empty: