Community Education Invoice

Community Education Invoice
Thank you for being a part of Oregon Coast Community College's Community Education Program! Use this form to submit a payment request for a class completed this term. Questions? Call us at 541-996-6222.
Name*

First NameLast Name
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Title of Your Class/Workshop
Date of Your Class/Workshop's Final Session (or Date of Single-Session Event)*

MonthDayYear
Date
Total Number of Hours (number of hours per session x number of sessions)*
Total Amount Due ($30 per hour x Total Number of Hours (above)
If Applicable: Total Amount of Supplies Purchased for reimbursement (Pre-approval required. Please email receipts to talaina.king@oregoncoast.edu)
If Applicable: Enter other amount due (available only in certain cases by pre-arrangement with OCCC).
SIGNATURE: Please type your name below. *
Instructor Feedback: Please share any concerns or suggestions about the facilities, marketing, or other support of your community education offering at OCCC.
Should be Empty: