ACPC Reimbursement Request Form

Please fill out the form below to submit a reimbursement request to the Austin Creek Parents Club.

This is a two-step process. After you submit this form, we will use Nickel, our secure payment platform, to send your payment via ACH.

Contact Information

This information will be used to contact you if there is an issue with your request.

First name*

Last name*

Email address*

Phone number*

Attachments

You must attach at least one receipt or invoice. If you are requesting reimbursement for multiple transactions, please include an attachment for each transaction.Attachments must not exceed 20 MB in size.

Attachment Batch #1

Select files (.pdf, .jpeg, .jpg, .png)*

Expenses

Expense #1

Date*

Amount*

Description*

Account

Class

Total Requested: $0.00

Please review your information and ensure it is complete. Upon successful submission, you will be sent an email confirmation.