ALTA REQUEST FOR REIMBURSEMENT FORM
PLEASE CHECK THE APPROPRIATE OFFICE;
______ Executive Committee
______ Council Administrator
______ Committee Chair
______ Regional Vice President
Name_____________________________Committee/Region________________
Address _________________________________________________________
City ________________________State ____________ZipCode___________
DATE ITEM/ACTIVITY AMOUNT
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The budget allows reimbursement for Pre-Approved POSTAGE, TELEPHONE, and COPYING expenses resulting from carrying out ALTA duties and responsibilities.
Activities which result in TRANSPORATION expenses must have prior approval by the ALTA Executive Committee if reimbursement is desired.
There is no allowance for MEAL and HOTEL expense reimbursement.
__________________________________ __________________________
Signature Date Social Security #
Make Check Payable to: _____________________________________________
Send Check to: ___________________________________________