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TLC Reimbursement Request

Please complete this form and attach required documentation in order to receive your reimbursement from The Local Church. Thank you for the ways you love where you are!

Name (first and last)

Email

Phone number

Mailing Address

Your reimbursement will most likely be mailed in the form of a check.

Requested Amount

Please select the line item(s) for this purchase

Please select the line item(s) for this purchase

Other:

Please upload your receipt or other documentation.