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The Beehive Alliance

Creating A Buzz Around Pediatric Mental Health

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BHA Member Reimbursement Request

Please email finance@thebeehivealliance.com with questions.

First name*

Last name*

Email*

Reimbursement Request Date*

Month

Day

Year

Receipt Date*

Date of items or services purchased

Expense Category*

Purchase Description*

Total Expense *

Preferred method of reimbursement. Zelle, Venmo, Check - Please add detail (who to make the check out to, Zelle and Venmo @)*

Receipt(s) Upload*

The Beehive Alliance is a 501 (c) (3)

non-profit organization (EIN: 85-1235719 )

Mailing Address:

The Beehive Alliance

1733W Lane Avenue #28

Upper Arlington, Ohio 43221

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