Complete and submit this form to request IFAF reimbursement.
Date: -- Month -- January February March April May June July August September October November December -- Day -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2004 2005 2006 2007 2008
Beginning Time: -- Hour -- 1 2 3 4 5 6 7 8 9 10 11 12 : -- Minute -- 00 15 30 45 AM PM
Ending Time: -- Hour -- 1 2 3 4 5 6 7 8 9 10 11 12 : -- Minute -- 00 15 30 45 AM PM
Note: 12:00 AM is midnight; 12:00 PM is noon.
Description of Activity:
Itemized Budget:
Burton 1
Burton 2
Burton 3
Burton 4
Burton 5
Conner 2
Conner 3
Conner 4
Conner 5
Your Name:
Email Address:
House Office(s) / Floor Office(s):
Note: A copy of this request will be sent to the floor chairs of each of the checked floors. If you would like additional copies to be sent elsewhere, please enter the additional email addresses in a comma-separated list below:
Note: Submitting this request does not substitute for presenting a proposal in person at ExecComm as described in the guidelines above.
