CSDSA EXPENSE REPORT
Name_____________________________________________Phone________________________
Address________________________________________________________________________
Email Address___________________________________________________________________
Description of item for reimbursement_________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CATEGORY OF EXPENSE
| $__________Advertising | $__________Buddy Walk | $__________Conferences |
| $__________Gifts | $__________Newsletter | $__________Overhead |
| $__________Social | $__________Teen Group | $__________Training |
| $__________Website | ||
| $__________Other, please explain_______________________________________________ | ||
Total request for reimbursement
$_____________________________________________________________
(remember to attach all receipts)
Office Use Only: Approval______________________________________________Date______________________ Date mailed____________________________________________Check#____________________ |