Reimbursement Request

Requesting a reimbursement via an ACH transfer. If you would like a check sent to you instead, please reach out to Ariela at ariela@hillel.columbia.edu

Comments
This field is for validation purposes and should be left unchanged.
Name*
First Last
School Email Address*

@columbia.edu or @barnard.edu
I'm requesting…*
- A reimbursement for myself
- A reimbursement on behalf of someone else
- A check to be sent to someone for their services (ie guest lecturer, etc)
If requesting a reimbursement for someone else, or asking for a check to be sent to someone for their services please be sure to write that person’s full name.
Full name of person receiving the reimbursement/check.*
What budget is this coming from?*
Please indicate the name of the group or initiative.
If indicated "Other" above, please explain
If you are still not sure please reach out to your staff advisor or to Ariela at ariela@hillel.columbia.edu before completing this form.
Name of event*
Date of event
MM slash DD slash YYYY
Please upload a picture or copy of your receipt or invoice*
Drop files here or

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 2 GB.
If you are submitting an invoice on behalf of a guest speaker who is coming unaffiliated with an organization, please include that person’s social security number on the invoice.
What is the requested reimbursement amount?*
Bank Routing Number*
Please write the routing number of the person who should receive the reimbursed amount.
Account Number*
Please write the account number of the person who should receive the reimbursed amount. If you would like a check rather than an ACH payment please reach out to Dena directly.
Your reimbursement will be processed after you submit a list of attendees of the event/the person you met with one-on-one*
- I submitted the google form with my list
- I am going to submit the google form with my list
- Not applicable for my reimbursement
Complete this form: https://forms.gle/wyd61nceJRNxWTtM7

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