Ministry Reimbursement
Please fill out this form to request reimbursement for approved ministry team expenses.
Reimbursement Information
Name (Check written to this name)
*
How would you like to receive your reimbursement?
*
Please select one option.
Pick up my check
Mail my check
Address to mail check
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Total Reimbursement Amount (Combine multiple purchases)
*
Budget Account to be charged to (if known)
Supporting Information
Email
*
This address will receive a confirmation email
Phone
*
Reason for purchase
*
Purchase authorized by:
*
Receipts
Upload (8MB)
Receipts
Upload (8MB)
Receipts
Upload (8MB)
Submit
Description
Please fill out this form to request reimbursement for approved ministry team expenses.
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