Chapter Reimbursement Form

After filling out the appropriate form, send a copy of the receipt(s) and the completed form to Roy Brinkerhoff at 284 HC Provo, UT 84602-2400, FAX: 801 422-0537 or scan and email to roy.brinkerhoff@byu.edu. A copy of the receipt(s) is required. Please do not send the form alone.

Expectations and Recognition Awards Reimbursement Form (PDF)

Out of Pocket Reimbursement/Donation Form (PDF)

Alternatively, fill out the webform below.

Expectations and Recognition Awards Reimbursement

If your chapter meets the requirements for True Blue or White recognition, you are eligible to receive recognition incentives. ($500 for True Blue or $250 for White). These funds are for replenishment grant use. They can also be used to reimburse a chapter member for travel to the Annual Chapter Conference, food or supplies for a chapter/student gathering. In order to receive these funds as reimbursement, this form must be submitted by the Chapter Chair. Funds will be available one month before and one month following the Annual Chapter Conference.

Out of Pocket Reimbursement

The local Chapter's bank account should reimburse the personal expenditure whenever possible. If the local chapter funds are inadequate, fill out this portion.

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.

Items

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

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx.