Reimbursement Request – Association For Compensatory Educators of Texas

Reimbursement Request

Reimbursement For *

Date *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Location

Requested By *

Airfare

Mileage

Lodging

Meals

Shuttle, Cab, etc

Parking

Telephone

Postage

Printing

Other Expenses

Total

$0.00

Please upload supporting evidence for reimbursement to be approved

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

Signature of Member Submitting Form

Clear Signature

Mail to:

Laura Witte, ACET Executive Director

P.O. Box 6203

San Antonio, TX 78209

Approved By:

Date Paid:

Check #

Account #