Fillable Scholarship Reimbursement Form Utilize this for out-of-pocket expenses (Oxnard College)

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Scholarship Reimbursement Form Utilize this for out-of-pocket expenses (Oxnard College)

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• Utilize this
Scholarship Reimbursement Form
for out-of-pocket expenses that qualify under your awarded scholarship criteria.
• Submit this form to the Oxnard College Foundation (OCF) office before the 2-year expiration date unless otherwise stated.
• Only (1) OCF reimbursement check per scholarship will be issued each semester.
• OCF will mail checks directly to the below address; therefore, please allow 10-14 days for processing.
NAME:
OC STUDENT ID#:
900
(Last )
(First)
ADDRESS:
PHONE NUMBER:
SCHOLARSHIP NAME:
YEAR AWARDED:
Attachments required per semester:
Students attach Oxnard College class schedule/bill showing classes, total units and out-of-pocket expenses showing and current
Student ID number.
Transferring students attach your University’s Academic Schedule showing classes, total units and out-of-pocket expenses with
current Student ID number.
Original itemized receipts for qualified books and educational supplies required in the class syllabus.
Additional information may be required to satisfy criteria for verification before funds are authorized.
Expense Reimbursement for Oxnard College or University:
(OCF Scholarship Policy for Reimbursement excludes housing, transportation, childcare or food expenses)
$
Tuition
$
Fees
$
Parking Permit
$
Books (New/Used or Rentals)
$
Educational Supplies (listed on the class syllabus)
$
Computer Equipment (OCF will only reimburse one computer per student)
$
Total Reimbursement for:
(Semester/Year)
Office Use Only
Approved for payment
Amount: $
Funds Available for next semester: $
Approved By:
Date:
(OCF Representative)
OXNARD COLLEGE FOUNDATION
Administration Building
4000 South Rose Avenue
Oxnard, CA 93033
(805) 986-5889 Office
(805) 986-5989
www.oxnardcollege.edu/scholarships
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Scholarship Reimbursement Form Utilize this for out-of-pocket expenses (Oxnard College)

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Completed 5 September 2020

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