UC Blue Ash: Student Group Reimbursement Form

This form is to request reimbursement from the UC Blue Ash College PNC Legacy Account. A receipt is required.

Name of Student Organization/Affinity Group Officer (submitting form)

Email of Student Organization/Affinity Group Officer (submitting form)

Phone Number of Student Organization/Affinity Group Officer (submitting form)

Student Organization/Affinity Group

Reimbursement Amount Requested

The check should be made out to:

Please describe the reason for the expense and the items/services purchased.

Name of Advisor

Email of Advisor

Upload a photo or PDF of all receipts/invoices for which you are requesting reimbursement.