Reimbursement Form | Threshold Choir

Reimbursement/Payment Request Form

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Name*

First Last

Email*

Chapter Name (no abbreviations)*

What are you requesting reimbursement/payment for?*

Amount of reimbursement/payment (in US dollars)*

Who should the check be payable to?*

Address where the check should be mailed:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Upload Receipt Here*

Accepted file types: jpeg, jpg, png, pdf, Max. file size: 100 MB.

Expense Account*

Please select which account you would like payment to be drawn from.

Reimbursement/Payment for a Threshold Choir Gathering

If your reimbursement/payment is coming out of a Gathering Account, please indicate the name and date of the gathering below:

Additional Details

Add any additional information here.