Reimbursement for Non-Travel.xlsm

	A	B	C	E	F	G	H	I	J
1	Reimbursement for Non-Travel Expense
2
3	Please describe all expenditures and attach receipts for expense approval.
4					Vendor
5	Name:				No.			Date:
6
7	Address:
8
9	School Name & Unit #:
10
11	Email:	___________________________________________________________________
12
13	Receipt Date		Vendor Name on Receipt			Purpose of Expenditure			Amount
14
15
16
17
18
19
20
21
22
23
24						TOTAL AMOUNT
25
26	Applicant Signature:							Date:
27
28
29	CPS Approval Signature:							Date:
30
31	FOR CPS USE ONLY
32	Unit		Fund	Account			Program		Grant
33
34
35	For all reimbursement requests, please retain copies of this completed form and all receipts for your files. Send this original form, with receipts attached to a separate sheet of paper, to your affiliate representative. Your affiliate will forward the information to CPS Grants Management,42 West Madison Chicago Illinois 60602 for final approval and reimbursement.
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100