Payment Request Form

Address *

Add your transactions

Please upload receipts or invoices. A receipt or invoice is required in order to be reimbursed.
Transactions *
Total Payment Amount (If have more than one transaction above):
Dollar Amount ($)
Upload Receipt/invoice or take a picture of the receipt or invoice. To take a picture, click on ‘Choose a local file’ then click ‘Take Photo’. (You must have a receipt or invoice to be reimbursed). *
Type email address of the Athletic Director or Treasurer of Sport to approve expense. If AD, type Book Keeper's email address.
AD/Treasurer Email *
example@example.com
Receive check *

Mail check Hand deliver check

Please click submit button below to submit request
This request will be submitted to the AD/Treasurer for approval.

If they approve the request, they will forward it to Genesis’ Book Keeper, Cassandra Carrizo for reimbursement. Please click submit button to request reimbursement.

Thank you.

Meeting place address

Add your transactions