EXPENSE REIMBURSEMENT REQUEST This field is hidden when viewing the formDate(Required) MM slash DD slash YYYY Your full name(Required) First Last Your Email(Required) Select Department(Required)A 1.0 - UtilitiesA 2.0 - SuppliesA 3.0 - Church InsuranceA 4.0 - TaxesA 5.0 - Maintenance and RepairsA 6.0 - Janitor and LandscapingA 7.0 - Professional ServicesA 8.0 - Church Equipment purchasesA 9.0 - Extraordinary itemsA 10.0 - AutoC 1.0 - Medical Insurance fundC 2.0 - Church MinistriesC 3.0 - Mission and CharityC 4.0 - Music MinistryC 5.0 - Youth MinistryC 6.0 - Camps and RecreationsC 7.0 - NW AssociationD 1.0 - Photo/Video ServiceD 2.0 - LibraryD 3.0 - Radio and Internet LiveStreamE 1.0 - Bible School MinistryE 2.0 - Russian School MinistryE 3.0 - Spiritual EducationF 1.0 - New ConstructionSelect Sub Department(Required)1.1 - Gas, Electric1.2 - Fire Service1.3 - Water, Sewer1.4 - Computer and Internet1.5 - Disposal Services1.6 - Alarm ServicesSelect Sub Department(Required)4.1 - Payroll taxes4.2 - Other taxesSelect Sub Department(Required)5.1 - General5.2 - Special ProjectsSelect Sub Department(Required)6.1 - Janitorial Supplies6.2 - Small tools & EquipmentSelect Sub Department(Required)7.1 - Software subscriptions7.2 - Equipment rental and leaseSelect Sub Department(Required)10.1 - Vehicle Insurance10.2 - Gasoline10.3 - Parts and MaintenanceSelect Sub Department(Required)2.1 - Kitchen2.1.1 - Kitchen tools2.1.2 - Kitchen Disposables2.1.3 - Food2.2 - Celebrations2.3 - Baptism2.4 - Christmas2.5 - Decorations2.6 - Couples MinistrySelect Sub Department(Required)3.1 - Unexpected social help3.2 - General (details in the description)Select Sub Department(Required)4.1 - Special projects4.1.1 - Main Choir4.1.2 - Men Choir4.1.3 - Women Choir4.1.4 - Youth Choir4.1.5 - Teen Choir4.1.6 - Kids Choir4.1.7 - OrchestraSelect Sub Department(Required)6.1 - Kids Camp6.2 - Teen Camp6.3 - Church CampEnter the total amount of the requested reimbursement:(Required)Who authorized this purchase?(Required) First Last Whom should the reimbursement be issued to:(Required) First Last Address where the check should be mailed to:(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Enter the DETAILS of what was purchased:(Required)What was the PURPOSE of the purchase?(Required)Upload your receipt(s) here: Drop files here or Select files Max. file size: 64 MB.