Fun Times Singers Request for Reimbursement

Name:
Date:  Phone Number:

Purpose of Expenditure:

Description of Items or Services Purchased:   number of items =

 VendorItemAmount
1$
2$
3$
4$
5$
  Total  $

Signature:                                                                                                     

Please attach receipts, make a copy for yourself, and turn in at rehearsal or mail to:

Lynda Stahl
396 Jai Drive
San Jose, CA 95119

Date Paid:                                           Check #:                     

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