1. Receipts must be attached to receive payment.
2. Alcoholic beverages are not allowable.
3. Upon completion, send this form with supporting documents to your district treasurer.
4. Payment will be made only after this form is approved by your District Treasurer and District Governor / Counselor.
5. In order to save the completed form fields and signatures, you must use either Adobe Acrobat or Adobe Acrobat Reader to view/edit this file. Mac users will want to make sure that the PDF did not open in Preview.
Form Updated 11/1/2022