Powering Progress Events Reimbursement Form

Thank you for hosting a Powering Progress Event!

You can use this reimbursement form for food, snacks, renting space, or other standard event supplies. You can request reimbursement for up to $200 per action. Simply keep your receipts and then submit this form. You can be reimbursed directly or through distributed fundraising.

If you are interested in this program but are finding any barriers (reimbursement is not sufficient to cover costs, concerns with reimbursement timeline, issues completing the form) please reach out to your Organizer to discuss further.

Note: Please remember that Powering Progress is a nonpartisan, non-electoral, non-lobbying project of Indivisible Civics, a 501(c)3 organization.

Name*

First Name

Last Name

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone Number

Indivisible Group Name*

Role in Group*

Total of Receipts - Amount Seeking to be Reimbursed* $

How would you like to receive your reimbursement?*

Direct Deposit Distributed Fundraising Account Check via mail

Account Number*

Routing Number*

Account Holder Full Name*

First Name

Middle Name (optional)

Last Name

Name of Group in Distributed Fundraising*

Distributed Fundraising ID

(optional)

Treasurer Name*

First Name

Last Name

Full Mailing Address for Check*

Address Line 1

Address Line 2

City

State

ZIP Code

How many receipts would you like to upload for reimbursement?*

Upload Receipt 1*

No File Chosen

File uploads may not work on some mobile devices.

Upload Receipt 2

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 3

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 4

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 5

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 6

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 7

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 8

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 9

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

Upload Receipt 10

No File Chosen

File uploads may not work on some mobile devices.

(optional for more than one receipt)

I verify that I am seeking reimbursement for approved purposes (including food, snacks, non-alcoholic beverages, party supplies, PPE, promotional materials, venue or other standard event supplies) for an approved Powering Progress event for my Indivisible group. I am not submitting reimbursement requests for any prohibited expenses (personal enrichment, donations to political campaigns/parties, or drugs/alcohol).

Please share one sentence about the event you held that you're seeking reimbursement for*

We would love to see pictures of your event. Would you like to share any photos with us?

Photo Upload 1

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 2

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 3

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 4

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 5

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 6

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 7

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 8

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 9

No File Chosen

File uploads may not work on some mobile devices.

Photo Upload 10

No File Chosen

File uploads may not work on some mobile devices.

Questions, Comments