Please complete this form for all PRE-APPROVED PCard reimbursements and approved general reimbursement requests. All documents (paper receipts, invoices, program/conference schedules, etc.) should be scanned and uploaded. No hard copies will be accepted. Someone will respond to your request within 2-3 business days.
* indicates required fields.
Requestor's Email *
Requestor's Phone (e.g. 650-555-1212) *
Personal Credit Card
Date of Transaction *
Amount ($) *
Name of Merchant/Vendor *
Expense incurred on behalf of (i.e. another person, program, class, etc.) *
This section provides the business justification for the expense, and must answer the questions Who, What, When, Where, and Why. Please be as specific as possible. *For business meals, a list of ALL attendees is required. If none, please provide a justification.
PTA-E (if applicable) *
*Please provide a scanned/electronic copy of the receipt, invoice, etc. *
*If missing receipt, please explain why:
Please skip. Do not fill this out.