Name

First Name

Last Name

PayPal Account

Trip

Format: Venue Type MMDDYY

Leader Fee

Mileage

Round-trip.

Mileage Reimbursement

$0.54 per mile

Misc. Expense #1

e.g., "Cheese @ Cowgirl Creamery" or "Golden Gate Bridge Toll"

Misc. Reimbursement #1

Amount to reimburse from item listed above.

Misc. Expense #2

Misc. Reimbursement #2

Misc. Expense #3

Misc. Reimbursement #3

Misc. Expense #4

Misc. Reimbursement #4

Have more than four extra expenses to be reimbursed? Just message @shelley on Slack!