Tulsa Master Gardener Foundation Reimbursement Request Form

Date____/____/____ Requested by:______________________________________

Phone:_____________________ Email:__________________________________

Committee:__________________________________________________________

Group / Project:________________________________________________________

Items Purchased / Description:____________________________________________

Group / Project:_____________________________________________________

Items Purchased / Description:____________________________________________

Committee Chair Approved:______________________________________________

Total Amount: $____________________ (Please attach receipts to the back of this form.)

Make check payable to (print):_____________________________________________

Address:_____________________________________________________________


Mail this approved, completed form with receipts to:

Douglas Youngdahl
9027 South Fulton Ave.
Tulsa, OK 74137-3588

PLEASE NOTE: All requests for reimbursement must be accompanied by this form, and approved
by the committee chair.

URI:/calendars/reimbursement.shtml   Date Modified:Wednesday, 27-Jan-2010 11:13:18 EST   Thursday, 18-Mar-2010 16:15:55 GMT