South Sudanese Enrichment for Families
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Expense Form

Expense Form

Complete and submit this form to request payment for expenses or services

Name *
Name
Phone *
Phone
Mailing Address *
Mailing Address
Select the correct program from this list:
If you're being paid to work, describe your service here, and if applicable include number of hours and agreed-upon terms of engagement (i.e. "Saturday Bridges Infant Program coordinator 5 hours at 25/hr."). - OR - If you're requesting reimbursement for expenses, (like Uber/Lyft, supplies, food, etc...) please describe it here (i.e. "Uber to Saturday Bridges for four people from Worcester" -OR- "4 dozen apples for Sat. Bridges snack"). ***If you have more than one expense, submit a separate form for each expense.***
Date *
Date
When was this expense incurred?
$
I have documentation (like a receipt or contract) to support this expense and I am sending it via email or text *
For reimbursement on an out-of-pocket expense (such as Uber or supplies), also text a picture of your original receipt to 781-322-0063 or email a pdf to SouthSudaneseBoston@gmail.com for our records. Thank you for your cooperation with this important step.
Also, if you have an agreement with SSEF that includes reimbursement for mileage, please include both the starting point and destination of your trip and the number of miles traveled here.

Once this form is received, it will be reviewed.  If there are questions, you will be contacted.  Otherwise, your request will be processed for payment within two weeks.

 

If you have any questions, email or call:

SSEF Boston Email:
SouthSudaneseBoston@gmail.com

Phone Number:
781-322-0063