HMA Reimbursement & Upfront Check Request
Use this form to request reimbursement for PRE-APPROVED expenses and check requests related to HMA supported activities. Our treasurer will review the request and respond in a few days. Please email us at
with any questions.
Name of person submitting the request
Email address of person submitting request:
Is this a reimbursement request or upfront check request?
Reimbursement - I have already paid and would like to be reimbursed.
Upfront check - I need to pay a vendor
If this is an upfront check, when do you need it?
Please give us 1 week notice if you need the check upfront if possible.
Reason for Reimbursement or Upfront Check
What event, activity or program is the reimbursement or upfront check for?
Which HMA fund should this be allocated to?
Check payable to:
Who do you want the check made out to?
How much is the reimbursement request for?
Mailing Address for check:
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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