Reimbursement Form
Baltimore Shambhala Meditation Center
Name
*
First
Last
E-mail
*
Program or Event
*
Expense Category
*
Ikebana
Food & Beverage
Alcohol
Household Supplies
Office supplies
Postage & Delivery
Printing & Reproduction
Repairs & Maintenance
Other
Total Expense
*
Attach Receipt
*
Choose File(s)
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of
Would you like to donate this expense?
*
YES
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Paid or entered as donated?
Yes
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Description of Expenses (optional)
How would you like to receive payment?
PayPal
Check in the mail
E-mail
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Total Expense
Less Cash Advance
*
Total Reimbursement
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