Avodah Honorarium Request Form

Temple Isaiah

Avodah T.A. Honorarium

Reimbursement Request Form

This form is intended to be filled out by current and past Avodah-nicks ONLY.

(Parents- please leave the requesting to your children. Thank you!)

T.A.'s First Name *

T.A.'s Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

T.A.'s Email Address *

Parent's Email Address *

Are you a current T.A.? *

Yes

What Jewish program or activity would you like to be reimbursed for? *

Date(s) of event: *

Reimbursement Amount: *

Who should we make the check out to? *

Do you have a receipt to upload today? *

Yes

I plan to email it to katie.berryhill@gmail.com (with subject line: "Avodah Request")

Receipt upload

Any additional information you would like us to have about this request?

I understand that my request is not complete until I have submitted proof of payment for the reimbursement I am requesting. If I have not uploaded my receipt today, I will send it to Women of Isaiah representative, Katie Berryhill, at katie.berryhill@gmail.com (with subject line: "Avodah Request"). Once I have done so, my request will begin to be processed. *

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