Approved Expense Reimbursement Request - Berkeley Public Schools Fund

Name of Requester*

Full name of person requesting reimbursement.

First Last

Email of Requester*

Email of of person requesting reimbursement.

Phone of Requester*

Phone of of person requesting reimbursement.

Amount requested*

Amount that you would like to be reimbursed for.

This payment is for

YOU, the requester
someone else

Name of Payee

If payment is to be made to someone other than you, please provide the payee name. If left blank, payment will be made out to the requester's name.

First Last

Email Address of Payee

Phone Number of Payee

Payment Type*

PayPal is our strongly preferred method as it avoids issues with checks lost in the mail or uncashed. We can issue a check if the recipient cannot receive PayPal payments. Checks will be mailed to the recipient.

PayPal to recipient (choose this if possible)
Check (if recipient doesn't have PayPal)

Address of Payee (check will be mailed here)*

Street Address City State / Province / Region ZIP / Postal Code

PayPal Account @name, Email or Mobile Phone*

Payee must have or set up a PayPal account. We can send PayPal payment to either an @name, email address or mobile phone number.

Reason for payment*

Please describe what the reimbursement is for.

Who approved this expense?*

Name of person or program that gave you approval to request reimbursement for this expense.

Copy of receipt(s)*

If you have a paper receipt, please scan or photograph and attach a copy here (filetypes accepted are jpg, gif, png, pdf). If you have a receipt in email, you can just forward the email to schoolsfund@berkeley.net.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.

Notes

Provide any additional information here.

Phone

This field is for validation purposes and should be left unchanged.