Programming Reimbursement Form Due Dates March 1 June 1 September 1 December 1 Organization Name:*Submitted By:*Phone Number:*Email Address:*Mailing Address:*Program Title:*Reimbursement Amount:*Please give a brief, but thorough description of the program and how it benefitted the community. Please be sure to address the following:How many people attended?*How did the attendees benefit from the program?*Will the program be repeated?*YesNoWhen?*Please give a brief description of how this program benefits the Black Apostolate in the Archdiocese of Philadelphia. Please be sure to indicate if the program is open other parishes, if applicable:*Please attach documentation of expenses*Consent* I agree to all submitted items being true to the best of my knowledge.NameThis field is for validation purposes and should be left unchanged.