HSC Reimbursements

Expense Reimbursement Form

Please upload all applicable receipts and/or vendor invoices when submitting this form.

If you do not already have digital copies, the easiest option is usually to take a clear, straight-on photo of your receipts or invoices and complete the form directly from your phone.

Once submitted, the request will be routed to the HSC Treasurer and HSC President for review and approval. Please reach out with any questions before submitting your reimbursement request.

Full Name

Phone number

Item(s)/Purpose*

Include Vendor Details, Items, Purpose and Amount.

Eg.

Amazon, Valentines Day decorations for 2nd grade - $25
Target, Valentines Day Goodies - $12

Total Reimbursement Amount Requested*

Upload Receipts/invoices*

Maximum of 10 files per submission. If you need to upload more than 10 files, please split your reimbursement into multiple submissions.

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Please sign to confirm the information above is accurate and complete.

Zelle is our preferred reimbursement method. Please provide the email address or mobile phone number associated with your bank account for Zelle payments. (Skip this section if requesting reimbursement by check.)

(If requesting a check) Make Check Payable To:

Check Delivery

Leave check in the HSC cubby (Lex front office) for pickup

Mail check directly to vendor

Any additional information that would help the Treasurer process this reimbursement request.