ABWA
MEMBERSHIP REIMBURSMENT FORM
Please fill
out the form and return it to Carlene Hinds for reimbursement of any seminar,
class, retreat, continuing education, etc.
The maximum reimbursement is $50.00.
Please turn in
no later than July 31st, 2010.
Any questions,
please call Carlene at 208-5740. Thank
you!!
Member Name: ______________________________________
Date of Event: ______________________________________
Type of Event: ______________________________________
Cost of Event: ______________________________________
Please provide
an address where you want your reimbursement check to be sent.
Signature
________________________________ Date _________________