Kevin McLaughlin Travel Fund
Reimbursement Form - Virginia Rainbow for Girls Foundation
Virginia Rainbow Girl's Name
*
First Name
Middle Initial
Last Name
Home Assembly Name
*
Phone Number
*
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
Your E-mail Address
Grand Jurisdiction Visited
*
Include State/Country, and the event you attended
Virginia Rainbow Chaperone and Companions
*
Include full name of chaperone(s) and any Rainbow Girls you are traveled with.
Expenses List
In the form below, itemize your expenses and then upload a PDF or image file of your receipts to correspond with each expense. Only the expenses with documentation will be reimbursed. Allowable expenses include registration fees, travel and transportation fees (airline tickets, train tickets, fuel, etc.), and hotel and lodging fees. Reimbursements will not be approved for dresses, gifts, or any other non-related expense. Grand jurisdiction events east of the Mississippi River will receive up to $150 in reimbursement. If traveling west of the Mississippi River, or outside of the United States, travel reimbursement is up to $300 of qualified expenses. One application per Virginia Rainbow Girl in good standing per Grand Term will be accepted. Travel funds given to attend Supreme Assembly do not prohibit a Rainbow Girl from submitting an application for a Grand jurisdiction event. Provide all dates in Month-Day-Year format.
Item Category
Purchase Date (MM-DD-YR)
Expense ($)
1
2
3
4
5
6
7
8
Upload receipt for Item #1
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Upload receipt for Item #2
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Upload receipt for Item #3
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Upload receipt for Item #4
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Upload receipt for Item #5
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Upload receipt for Item #6
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Upload receipt for Item #7
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Upload receipt for Item #8
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Total Cost of Trip
*
Please make sure to calculate your total accurately as you have listed expenses in the table above.
Name of Person Submitting the Form
*
First Name
Last Name
Certification of Expenses
I certify that all information entered above is valid and true.
Signature of Person Submitting the Form
*
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