accreditation

You may also download this form to complete and return by mail. To request a copy by mail please call 888-559-2267.

PLEASE PROVIDE THE FOLLOWING:
*Name*
*Camp/Company*
*Address*
*City*
	ST *Zip*
*Phone*
*Email*

CAMP	# MILES	PER MILE	MILEAGE DUE	MEALS*	HOUSING*	OTHER*	TOTAL
1.		.32 cents
2.		.32 cents
3.		.32 cents
4.		.32 cents
*Original Receipts are required for reimbursement. Mail receipts to ACA Texoma, PO BOX 472264, Garland, TX 75047. Please include Visitor signature on back of each. Photocopies can not be accepted. Thank you for your understanding.
						TOTAL:

Check this box if you wish to donate your mileage. By checking the box and returning this form, you will receive a letter acknowledging an “in-kind” donation for tax related documentation. All donations are tax deductible and in kind donations will help to lower the Texoma Section expenses and enable the section to offer more services in other areas to our members and camps.

ACCEPTANCE
Initial here to indicate that this form is complete and accurate.