Oak Hill Classical School

Teachers Name *

First

Last

Vendors Name *

Please itemize this purchase and what needs reimbursement. *

From which bank account will this be paid? *

This amount should be charged to which of the following budgets? Check all that apply: *

Date of Purchase *

Total Amount to be Reimbursed *

If you chose more than one budget to which the amount should be charged, please split the total amount and indicate how much should go to each budget you chose:

By writing my full name in the box below and submitting this expense report, I certify I am Admin at Oak Hill Classical School and that this application is correct. I have checked the Oak Hill budget and ensured this expense does not exceed the intended budget.

Signature *

Your Name *

Today's Date *

Reimbursement Request

Reimbursement Request