NORTH COLONIE YOUTH BASEBALL, INC.

EXPENSE REIMBURSEMENT REQUEST FORM

NAME: ____________________________________            DATE: _______    ______

EXPENSE:   (ATTACH RECEIPTS)    

Date(s) incurred: ____________________________________________

                                                                                              Amount

Gas                                                                             $___________________________

Printing/Copying                                                      $___________________________

Maintenance/Repairs                                                          $___________________________

Equipment                                                                 $___________________________

Postage                                                                       $___________________________

Uniforms/Hats                                                          $___________________________

Concession                                                                $___________________________

Other (specify)                                                         $___________________________

_______________________________              $___________________________

_______________________________                          $___________________________

TOTAL EXPENSES:                                             $ ‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗‗

APPROVED: ___________________               Date:   ____________________