CLIPCO Expense Reimbursement/Check Request Form
Check will be payable to this name
Check will be mailed to this address
All communication and a .pdf copy of this request will be sent to this email address
Meyerholz Elementary School
Miller Middle School
Combined School (ASEP, Graduation, CLIPCO Administration Expenses)
Description of Purchase
Please list general description of expenses and purpose
If you have multiple receipts, please add up your total amount and list here
See Category and Subcategory List here:
. If you have multiple expenses in different categories, you must submit a new form for each category.
CLIPCO Administration Expenses
Chinese New Year Parade
CLIPCO T-shirt Expenses
Professional Development - Training and Conferences
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This form was created inside of Cupertino Language Immersion Program Community Org.