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Reimbursement/Check Request

  • This form is to be used by volunteers, teachers, staff and administration when requesting reimbursement for budgeted expenditures and approved funding requests.

  • This is the name that will be printed on the check.
  • Please select the type that most appropriately applies to the Payee.
  • Reimbursement Information

  • Combine multiple receipts into one check payment amount.
    Please enter a number greater than or equal to 0.5.
  • Please describe the purpose for the reimbursement and a summary of the items purchased. Do not list each line item on a receipt.
  • For simplicity, you may take a picture or scan a printed receipt and upload. For online purchases, save the receipt to PDF format and upload.
    Drop files here or