Small Credit Union Grant Reimbursement Form

Congratulations on being selected by the Carolinas Credit Union Foundation as a grant recipient. Please complete the form below so your reimbursement will be processed. Please remember to upload all receipts below. Checks are processed on Monday of each week, and Vizo transfers are processed for payment on Mondays and Thursday. If you have questions or need further assistance, please contact Lauren Whaley or Jeff Hardin.

Name of Credit Union(Required)

Please provide a breakdown of expenses below.

Name of conference or training:(Required)

Conference or training cost:

Total accommodation and meal expenses (if applicable):

Please attach any receipts (multiple attachments can be submitted):

Drop files here or

Max. file size: 50 MB.

If your credit union is a member of Vizo Financial, please provide the account number:

If you would prefer a mailed check, please provide the mailing address:

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