Expense Reimbursement Request Form

This Expense Reimbursement Request Form is meant to serve as a way to streamline the reimbursement process and payment process of all invoices and out-of-pocket expenses. Please fill out the specific details and it will be routed to the Treasurer of your organization or ministry. If you have any questions, please feel free to contact any of the Officers.

This Expense Reimbursement Request Form should be completed immediately after the purchase to ensure a prompt reimbursement or payment and also to secure all details concerning the particular event or item.

Please submit ONE form for EACH EVENT (multiple receipts for the same event is allowed). To process reimbursement requests, a receipt is REQUIRED for each invoice/receipt and must be attached and submitted with this form.

Requestor Information

Reimbursement Requested By(Required)
Name of person who will be reimbursed
Address to send payment to(Required)
Enter the address where the check should be mailed

Event Information

Select the organization you are requesting reimbursement from:
Select date MM slash DD slash YYYY

Invoices/Receipts

You may submit multiple receipts for the SAME event only. To process reimbursement requests, a receipt is REQUIRED for each invoice/receipt.
Please enter a number greater than or equal to 0.
Drop files here or
Max. file size: 20 MB.


    Please include all receipts for the event.
    This field is for validation purposes and should be left unchanged.