Please complete the form below to request reimbursement.
You must attach receipt(s) using the Upload Receipt field at the bottom of the form.

Reimbursement Request
Address
City
State/Province
Zip/Postal
Country
Enter the name of the event related to this reimbursement request. Enter only expenses related to this event.
Check all that apply
Allowable expenses for regional event reimbursements: 1) Professor / Senior Instructor Travel (hotel, airfare, mileage, food); 2) Hall / Equipment Rental.
If multiple items, list each item separately with amount for each item. For travel mileage, list mileage round trip, starting point, destination and parking/toll costs. Mileage Cost = Total Miles X $0.40
Total amount of expense of items listed in Description of Expense. Mileage Cost = Total Miles X $0.40
Your donation may be tax deductible. Please consult your tax advisor for details.
Enter the amount of reimbursement you wish to waive and donate to the AJJF
Enter the amount you wish to be reimbursed. If you are only eligible for partial reimbursement, enter that amount.
If you would like the check made out to, for example, your dojo name instead of the name at the top of this form, enter that name here.
Drop a file here or click to upload Choose File
Maximum upload size: 134.22MB
Attach receipt for all purchase reimbursement requests. Maximum 6 attachments. If you have more than six, either combine into fewer files or submit a second form with the additional files. If you are unable to scan receipts, please submit this form anyway and email finance@ajjf.org for assistance.
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