Chapter Reimbursement Forms

Option 1: Select which type of reimbursement (Travel OR Out-of Pocket) | Fill out the required fields | Attach receipts | Click SUBMIT

Option 2: Dowload the form for the type of reimbursement using the links below (Travel OR Out-of-Pocket) | Complete the form | Send a copy of the receipt(s) and the completed form to Roy Brinkerhoff at 284 HC Provo, UT 84602-2400, or scan and email to
Travel Reimbursement Form (PDF)
Out-of-Pocket / General Reimbursement (PDF)
Donation Form (PDF)

Travel Reimbursement

Periodically, funds are awarded that can be used to reimburse a chapter member for travel to the annual Chapter Conference. To request a reimbursement for travel, this form must be submitted by the Chapter Chair. Itemized receipts are required. Travel reimbursement may include airline, rental car, gasoline, and hotel expenses. The deadline to submit reimbursement requests for the Chapter Conference is November 15.

Out-of-Pocket Reimbursement

The chapter's local bank account should reimburse personal expenditures whenever possible. If the local chapter funds are inadequate, use this form to request reimbursement.

Out-of-Pocket Donation

When the out of pocket expense is considered a charitable contribution to BYU, complete this portion. A copy of the receipt(s) is necessary.


Please be sure to include a description of the item, the amount the item cost, and the amount you would like to have reimbursed.

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