H&S Reimbursement Request Online Submission Form

*Receipts must be submitted. Any requests submitted without receipts will be returned to you for supporting documentation.

Please complete the form below to submit your reimbursement request. Thank you for all that you do for St. Augustin Catholic School! We appreciate your support.

Questions? e-mail the Home and School Association Treasurer.

Name

Phone

Purpose of Expenditure

Committee or Budgeted Program

Committee Chair

Check payable to

Delivery of Check

Pick Up in Office

Home with Child

Other

If Home with Child - provide name + grade / If other - please provide delivery instruction

Detail of Expenses to Reimburse* - Please list expenses with dollar amount(s)

Total Expenses

Upload your receipt/documentation - submit 1 photo or combined document with your full receipt(s) **jpeg, jpg, png, or compressed PDF file types are best.

I would like to Donate some or all of my expenses to St. Augustin Home & School Association

Yes

Donation Amount

Additional Comments