Marketing Materials Reimbursement Request

General Information

Student Group*

REMINDER: Each Student Group is eligible for ONE LIFETIME disbursement

Full Name of Student Leader (First Last)*

Person who made the purchases

BU Email*

PERSONAL BU email of the person who made the purchases

Student Address (reimbursement check will be mailed here)*

Street Address Address Line 2 City State ZIP Code

Make sure you have access to this address for the next 6-8 weeks!

Receipt/Reimbursement Information

Confirmation of eligibility*

Yes

I confirm that I read the Marketing Materials Fund page on the SCOMSA website in its entirety, that my student group is eligible for this fund, and that we have not depleted this fund. I further confirm that we have reached out to SCOMSA regarding any material purchases that we are not sure is eligible and that we understand SCOMSA reserves the right to decline to reimburse any purchases that are judged by the Executive Board to be ineligible.

Confirmation of storage*

Yes

I confirm that we have discussed and secured a location to store these materials in and that it is NOT in the SAO closet. I further confirm that we understand that these materials must be passed down to future student leaders and that SCOMSA will NOT disburse this fund to my student group again in case we lose or damage our items.

Materials Purchase Date*

MM

DD

YYYY

Enter the Total Cost*

Expected amount you will receive from SCOMSA*

This cannot exceed $60

All ITEMIZED Receipts (PLEASE READ): Scan and upload ONLY ONE RECEIPT per .pdf or .jpg. PLEASE NAME FILES: "Last Name, First Name MM-DD-YY dollar.cents" (For Example: Doe, Jane 12-25-16 100.00)*

You must submit documentation that says some amount has already been paid. Your name and the name of the vendor/business must be clearly visible on the receipt.

Drop files here or

Special Permission for Purchases

If you reached out to SCOMSA and received special permission to purchase something that is not clearly delineated on the guidelines, please attach a PDF or screenshot of the approval email here.

Drop files here or

Please list all other sources and amounts of outside funding (includes out-of-pocket costs, department funding, grants, etc.)

Outside Source of Funding	Amount

Additional Comments

Confirmation of proper receipts*

I uploaded only itemized receipts with the proper file name format and with my name and the vendor's name visible. I understand that failure to follow these guidelines may delay my reimbursement.

Confirmation Email*

I am aware that I should receive an automated confirmation email within minutes of submitting this form and a personal email from Nichole, Director of Student Affairs.