District 31 Expense Reimbursement Form
Please submit within 1 week of purchase.
Sales Tax will not be reimbursed on MA purchases – please use tax exempt form

July 1 – December 31 Final expenses must be submitted by January 15, 2017
January 1 – June 30 Final expenses must be submitted by June 30, 2018

Email address *
Date *
MM
/
DD
/
YYYY
Reimbursement Request *
Indicate details: club name or # / area / division, event type, purpose such as TLI, Conference, Contest, Administration
Which level is this for? *
Reimbursement Payment Check should be made out to:
Name *
Street Address *
City, State, Zip *
Reimbursement Item #1
Type/Description
Postage, Telephone, Travel, Supplies, Equipment, Copying, Food, etc.
Amount
Purchase date
MM
/
DD
/
YYYY
Reimbursement Item #2
Type/Description
Postage, Telephone, Travel, Supplies, Equipment, Copying, Food, etc.
Amount
Purchase date
MM
/
DD
/
YYYY
Reimbursement Item #3
Type/Description
Postage, Telephone, Travel, Supplies, Equipment, Copying, Food, etc.
Amount
Purchase date
MM
/
DD
/
YYYY
Reimbursement Item #4
Type/Description
Postage, Telephone, Travel, Supplies, Equipment, Copying, Food, etc.
Amount
Purchase date
MM
/
DD
/
YYYY
Reimbursement Item #5
Type/Description
Postage, Telephone, Travel, Supplies, Equipment, Copying, Food, etc.
Amount
Purchase date
MM
/
DD
/
YYYY
Total Amount Requested
Total *
Upload Receipts
Receipts *
Required
For District Administration Use Only
Approval by District Director
X
Approval by Finance Manager
X
Approval by Support Director (if needed)
X
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Additional Terms