Delmar Dolfins Swim Club, Inc.

Reimbursement/Expense Form

Billings and receipts must be attached to this form for the club's records.

Reimbursement(s) Check Number(s) - ____________

Item	Purpose	Amount Paid
	Total Reimbursement

Expense(s)

Item	Purpose	Amount Paid	Check Number
	Total Expense

Date - ________________ Issued to - _______________________

Committee/

Program Area - ___________________