Student Organizations - Personal reimbursement request

Use this form to submit a reimbursement request for operating expenses and supplies. All requests must be submitted within 14 days of the purchase date on your receipt(s).

Fields with asterisks (*) are required.

Receipt Requirements

All receipts MUST show:
• Where the items were purchase – Store/Company Name
• What was purchased (Itemized list of what you bought)
• Payment method (via credit card xxxx1234)
• All receipts must indicate that a $0 balance is due.

Documentation Requirements

Reimbursement requests for items purchased for specific activities or meetings must also include a flyer showing the event date and details, or an email invitation for the meeting. In some instances a sign-in sheet might be required.

Payee Information

First name *

Last name *

Email *

WSU AccessID

WayneBuy Verification: Have you been reimbursed before? If you check NO, further instructions will be sent to within 3-5 business days with how to register in the WayneBuy system. *

Yes

Mailing Address (Note - The address that you provide must match the address that you have listed in Academica)

Student Organization:

Expense Information

Indicate why you made this purchase/brief description of the items:

Reimbursement Total

$ dollars . cents

Attach Receipts and Documentation (upload PDF of receipts)

Receipts for the purchase. Do not upload images, cut and paste into one Word document if necessary.

Flyer/Email invitation about the event

Attendance List (if catering was provided)

Receipts and Documentation Upload 5

Receipts and Documentation Upload 6