Request for Reimbursement of Funds

Name*
Who should we make the reimbursement cheque out to?
First Last
Email:*
Phone:*
Event or Item:
Please include details ie: Jane Doe Workshop on, or photocopying for …
Date of Event or Purchase:
MM slash DD slash YYYY
Committee:
Which committee’s budget does this expense come from?
This field is hidden when viewing the form
Budget Line Number:
Amount:
Total amount of reimbursement (Please specify in notes if total is in CDN or USD, USD Totals will be converted to CDN by our Treasurer, with a small conversion fee)
Notes
Please attach your RECEIPTS
Requested amount must match receipts.
Drop files here or

Max. file size: 64 MB, Max. files: 10.
Mailing Address:
Please include your mailing address if cheque is to be mailed.

Street Address Address Line 2 City Province Postal Code

1 Comment

Ranan Garfinkkle on August 5, 2025 at 10:45 am

Hi Mike,

I sent you an e-transfer request for payment for $230

Comox Valley Unitarian Fellowship