4-H Reimbursement Form
Teton County 4-H Council Claim Form
Name:__________________________________________________________________
Mailing Address:________________________________________________________
Purposed of Expenditures:______________________________________________
| Payment Details | Payment |
|---|---|
| Total |
Submitted By:_______________________________Date:______________________________
Approved By:________________________________Date:______________________________
Submit claim and receipts (original or copy) to:
Teton County 4-H Council
PO Box 130
Choteau, MT 59422
teton@montana.edu
Please leave blank for office use.