EXPENSE REIMBURSEMENT FORM

All requests for money must be cleared through your committee chair (if applicable) and either the President of the Community or the Treasurer.  No expenses will be reimbursed without: (1) prior authorization, (2) receipts (attach), and (3) this form, completed and mailed to:

Treasurer,

Penn Charter Community

3000 W. School House Lane

Philadelphia, PA 19144

Name:______________________________ Date:_______________

DATE

REIMBURSABLE EXPENSE

COMMITTEE/EVENT/ PURPOSE

AMOUNT

TOTAL TO BE PAID ________________

Check to be made payable and sent to:

__________________________________________

__________________________________________

__________________________________________