Reimbursement Form 2018 (Staff, Interns, Volunteers) *make a copy and rename*
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Purchase Detail
(please submit receipts for all purchases)
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Requester's Name: Phone Number:
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Email Address:CoachArt Office:
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Mailing Address:Date of Submission:
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Purchase Detail
(please submit receipts for all purchases)
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Description of items purchasedName of Activity or Event
e.g. Baseball Club
Expense CategoryAmount
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Total $ -
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Employee Initials:
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Supervisor Initials:
Date:
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For Reference
IN-HOME LESSON BUDGET FOR 8 WEEKS
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Category1 student2 students3 students
4 students
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Music$22$28$38$48
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Cooking$180$210$240$270
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Art$85$90$95$100
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Sports$50$55$60$65
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