CHESS MATES FOUNDATION
"Providing children with opportunities to learn live skills for today’s world."
INSTRUCTION REIMBURSEMENT FORM
TODAY’S DATE:______________________________
NAME OF SCHOOL:_____________________________________________________
NAME OF INSTRUCTOR:_________________________________________________
DATE OF EACH SESSION:__________ __________ __________ __________
__________ __________ __________ __________
TOTAL NUMBER OF SESSIONS:_________________
TOTAL REIMBURSEMENT DUE: $________________($30 per session)
APPROVED BY:______________________________(Program Coordinator)
For reimbursement, please mail this form to:
CHESS MATES FOUNDATION
2208 NW MARKET STREET
SUITE 313
SEATTLE, WA 98107
Your general comments and suggestions help improve Chess Mates’ programs. Please use the space below to share your ideas. Let us know what we can do to support your program.
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FOR OFFICE USE ONLY