E+I Fellows Student Reimbursement Request

Use the form below to submit your requests for any items or services you would like to purchase or for reimbursement as part of the E+I Fellows program.

Name*
First Last
Email*
Phone
Student ID*
Host Organization Name
Item For Reimbursement*
Item Name Brief Description Price Total Price for this item
Total Cost of Reimbursement*
Expense Justification*
Why is this necessary for your internship? What do hope to accomplish by purchasing this product and/or service?
Type of Approval Sought*
Please select whether these expenses should be purchased for you by Emma OR if you would like to purchase these items on your own and be reimbursed.
- These expenses should be purchased by Emma once approved.
- I am requesting reimbursement for already purchased-items or services.
Screenshots*
Please upload receipts and/or screenshots for reimbursement as a PDF file. This should include the the item, price, and any other relevant information.
Drop files here or

Max. file size: 100 MB.

Item Name	Brief Description	Price	Total Price for this item

E+I Fellows Student Reimbursement Request

Questions? Click here to contact E+I.