Action Ambassador Debrief

Name of event host:*

Host email:*

Phone*

Date of event:*

Number of attendees:*

Please provide a brief review of your event? Did you consider it a success, what did the guests say, any other comments that are helpful?*

Please provide attendee list here with all names and emails:*

Name	Email

Are you requesting a host reimbursement?*

Yes
No

If yes, please provide a written list of expenses incurred for this event.*

Item	Price

Ex: $40 appetizer platter, $50 drink tickets, $10 printing and postage for invites.

Would you prefer to receive a check mailed via USPS or an electronic transfer of your reimbursement directly to your checking account? If check, Please provide address to send reimbursement check

Check
EFT

If check, Please provide address to send reimbursement check

If EFT, please provide the following:

Bank Name
Checking Account Number
Routing Number

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