PRT Reimbursement Request 2017-18
Please complete this form and either scan and email your receipt to prt@scclc.net or put a copy of the receipt in the PRT Treasurer folder. Thank you!
Last Name *
Your answer
First Name *
Your answer
Email Address *
Your answer
Mailing Address *
Reimbursement check will be mailed to this address.
Your answer
Expense Date *
Your answer
Expense Amount *
Your answer
Description of Expense *
Please provide a detailed description of the expense (i.e. Coffee from Starbucks for Staff Breakfast)
Your answer
What class is this expense for? *
Select educator, if applicable, from pulldown menu:
What grade level is this expense for? *
If you are completing this on behalf of someone else, please list name/contact info for the person who should receive reimbursement. You may also use this space to add any other comments.
Your answer
Thank you!
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