EmailMe Form - Purchase or Reimbursement Form

Name *
Prefix First Last Suffix
Email
Phone
### - ### - ####
Today's Date *
MM / DD / YYYY
Ministry/Event: *
Is this for a purchase request or reimbursement of approved purchase? *
Purchase Request
Reimbursement Request
Other
Date Needed or
Purchase Date *
MM / DD / YYYY
What specifically will the funds be used for? *
Itemize your expenses:
Name of Item/ Description and Amount *
i.e. Orange Juice $3.99
Total Amount of Request/ Reimbursement *
Accountability Statement
After prayerfully considering the needs of the ministry and or event I am serving in at Destiny Worship Center, I submit my requests.
Electronic Signature *
Include Copies of Receipts or Estimate