KS SHRM Chapter Event Reimbursement

Name of Chapter Event *

Date of Event * +

Chapter Hosting the Event *

Upload Event receipts

Reimbursement Amount Being Requested *

Apprentice Information

Name of Apprentice *

List the Specific HR Training the Apprentice Will Receive *

Chapter *

Select One *

$250 Chapter Grant

$500 Business Referral Award

Reimbursement payment will be sent to:

First Name *

Last Name *

Email Address *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *