Request for GBU Sharing Funds 4254 Saw Mill Run Blvd., Pittsburgh, PA 15227
District Information
District Number City/State Date of Event or Period of Activity Type of Activity or Event What is the purpose of the Event or Program?
Event/Activity Information Itemize expenses and attach copies of receipts to this form. All receipts and copies of cancelled checks must be attached to this form along with an itemization of expenses. If receipts are unavailable, give detailed explanation for expense. Failure to comply with this request may result in refusal of request for Sharing Funds.
Authorization
Total Cost to District
$
Signature of President
Date:
Signature of Secretary/Treasurer
Date:
Prepare an original and copy, retaining copy for district record, mail the original to the GBU Community Engagement Team. HOME OFFICE USE ONLY: The above request for Sharing Funds Reimbursement has been: Approved Denied If denied, provide reason:
Phone: 412-884-5100 | 800-765-4428 | memberbenefits@gbu.org | gbu.org SHARE_FUNDS-1123_4
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