Reimbursement | Salem Christian Academy

EXPENSE REIMBURSEMENT REQUEST

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Date(Required)

Your full name(Required)

First Last

Your Email(Required)

Select Department(Required)

Select Sub Department(Required)

A10

Select Sub Department(Required)

Enter 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/purpose:(Required)

Upload your receipt(s) here:

Drop files here or

Max. file size: 64 MB.

Is your receipt for service(s) or item(s)?(Required)

Service(s)

Item(s)

If physical item(s) was purchased, make sure you've taken a picture of it and attach along with a receipt.

Upload picture(s) of item(s) purchased:(Required)

Drop files here or

Max. file size: 64 MB.