Volunteer Reimbursement Form

Attachment: 4071/COSA_Volunteer_Reimbursement_Form_3.15.24.pdf

Date

Description/Vendor

Amount

Receipt

Submitted

10/01/24 Example: Purchase of 3 Vendor Badges, Lewis Clark Traders

$30.00

Total:

Volunteer Reimbursement Form

Instructions:

• Please provide your contact information in the form below so we know where to send
your reimbursement check.
• For each reimbursable expense please provide the date, a brief description of the
expense including the identity of the vendor, and the amount.
• Please confirm that you have attached a receipt for each expense by checking the box
marked “Receipt.”

No expenses will be reimbursed without a receipt.

• Submit your completed reimbursement form along with receipts to
[email protected]

within one month of the expense date

.

Ver. 3/15/24

Name:

Date:

Address:
Email:

Phone:

Please note the following:

It is a best practice to obtain a pre-approval for expenses that you anticipate might need to be
reimbursed.  Doing this guarantees that we can make the reimbursement.  To do this, submit a
completed COSA Event Payment Request Form.  You can download the form here:
https://conventionofstates.com/grassroots-events-forms

✔

$ 0.00

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Created:	2022-11-29 15:44 GMT
Updated:	2024-12-01 00:00 GMT
Published:	2022-11-29 02:00 GMT
Converted:	2025-11-11 12:25 GMT
Change Author:	Convention of States
Credit Author: