VMCN Reimbursement Request

Expense Reimbursement Request

Please complete this form to request reimbursement for approved Valley Mission Center Network ministry expenses. Upload a clear copy of your receipt before submitting. Requests will be reviewed before being forwarded for payment.
Submitter Information

Please provide your contact information so we can process your reimbursement request.
Name

First NameLast Name
Email
example@example.com
Reimbursement Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Expense Details

Please provide information about the expense being submitted for reimbursement.
Date Submitted
Church
Budget Category
Project / Event
Ex. "Zillah's AV Upgrade," "Fall Camp Meeting," "Newsletter Flyers," etc.
Total Amount Spent
Enter the total amount of the attached receipt(s). Approved reimbursement will be determined according to the applicable Valley Mission Center Network reimbursement policy.
Receipt Upload

Please upload clear images or PDF copies of all receipts related to this reimbursement request.
Upload Receipts

Upload one or more receipts related to this reimbursement request.
Cancelof
Certification
Initials
Approval Information

For Valley Mission Center Network administrative use only. Complete this section after reviewing the reimbursement request.
Current Available Funds
For Specific Budget Item / Church
Approved Reimbursement Amount
Amount approved for reimbursement.
Approved By
Approval Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
New Remaining
Remaining budget balance after this reimbursement is approved.
⚠️ Budget Verification
The approved reimbursement exceeds the current available balance. Please verify that additional funds have been authorized before approving this request.
Budget Exception Notes
Record any information that supports or explains the approval decision. This note is for administrative reference and may be included in the treasurer’s notification if desired.
Initials
Should be Empty:

Expense Reimbursement Request

Submitter Information

Expense Details

Receipt Upload

Approval Information