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Ally Reimbursement Form
Please submit your request by completing this form, allowing 7-10 business days for reimbursement.
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* Indicates required question
Your full name or organization name (with contact).
*
Your answer
Contact phone number
*
Your answer
Date of meeting or event
*
MM
/
DD
/
YYYY
Purpose
*
Your answer
Amount to be reimbursed
*
Your answer
What is preferred method of reimbursement?
*
Please choose one.
Venmo
Check
Paypal
Zelle
Other:
If reimbursed via Venmo or Paypal please provide your user ID
*
Your answer
Address (needed for checks)
Your answer
Please take a picture of the receipt and send it to us WITH NOTATION.
*
I am texting this image to 502-905-0242.
I am emailing this image to
finance@arizetogether.org
.
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