Fingerprinting Reimbursement Request - Berkeley Public Schools Fund

Volunteer Name*

Full name of volunteer.

First Last

Email*

Phone*

Amount requested*

Fingerprinting cost that you would like to be reimbursed for.

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)

PayPal Account @name, Email or Mobile Phone

PLEASE MAKE SURE THIS INFORMATION IS ACCURATE! Payee must have or set up a PayPal account. We can send PayPal payment to either a PayPal @name, email address or mobile phone number.

Name of Payee (if different)

If check is to be made out to someone other than the volunteer, please provide the payee name. If left blank, check will be made out to volunteer name.

First Last

Address of Payee

Check will be mailed here.

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

Copy of receipt*

Please scan or photograph your fingerprinting receipt, and attach a copy here. (Filetypes accepted are jpg, gif, png, pdf)

Drop files here or

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

Notes

Provide any additional information here.

Comments

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