Reimbursement - Triad Pride Performing Arts

form to submit for reimbursement

Event or Production name this is related to
Description of request*
What budget category should this be charged to?
Amount*
Please enter a number from 0 to 3500.
Date needed*
MM slash DD slash YYYY
Who should the check be made out to?*
should check be mailed?*
- Yes
- No
Yes/No or other please list IE night of event, to rehearsal etc
Where should the check be mailed
Street Address Address Line 2 City State ZIP Code
please attach receipts, contract, or invoice
Drop files here or

Max. file size: 256 MB.
Additional comments or notes
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