TWCP Cavalier Robotics Booster Club

TWCP Cavalier Robotics Booster Club

EXPENSE | REIMBURSEMENT REQUEST FORM
REQUESTED BY:

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
DATE SUBMITTED:

MonthDayYear
Date
PURPOSE OF REQUEST:
NOTE:

Purchases exceeding $250 for an individual item must first have Booster Board approval prior to purchase. If item listed is not budgeted, this form will serve as a request pending approval.
PURCHASE
Mentor Approval
Budget Category
Amount
Budget Category
Amount
Budget Category
Amount
Budget Category
Amount
Total Reimbursement:
Send to me by:
Upload W-9 if paying to a 3rd party

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Upload original receipt(s)

*Circle amounts on receipt to ensure correct payment. Please use Tax Exempt forms as we do not reimburse for Sales Tax.
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Signature
Authorized Approver:
Authorized Approver:
Internal Use Only:
Check # | Date | Amount
Treasurer Signature:
Should be Empty:

NOTE: