FLEX / YES – Activity Advance Request

Flex Yes – Activity Advance Request

Activity Advance Request

Name

This field is for validation purposes and should be left unchanged.

Local Coordinators may request funds in advance for enhancement activities. Requests must be accompanied by a completed Enhancement Activity Proposal form. Upon approval, up to 80% of the total activity budget will be sent to you directly from the Accounting Office. Please bear in mind that the processing time for the advance will be 10-15 days.

Local Coordinator Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Total Budget for Activity(Required)

Advance Request Amount (maximum is 80% of total budget)(Required)

I understand that when submitting my expense report for this activity, I must deduct the advance from my total expenses and Greenheart will reimburse me any balance owed. Furthermore, I agree should I not spend the entire advance I will submit with my expense report, a check for any amount remaining to Greenheart. If no detailed expense report is submitted or I fail to submit repayment to Greenheart, Greenheart is authorized to deduct payment from any payments that may be due to me.

Please read and check to proceed(Required)

I verify that I have also submitted a completed Enhancement Activity Proposal Form

I verify that I have read the above and agree to the terms and conditions.