HMA Directors Credit Card Charges
Directors - use this form to submit credit card charges on HMA cards. Please email us at
with any questions.
Name of person submitting the request
Reason for Charge
What event, activity or program is the reimbursement or upfront check for?
Which HMA fund should this be allocated to?
How much was the charge for?
Date of Charge
Have you emailed your receipt to
Yes, I've email to
No, I've submitted in another way approved by a board member
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