Benefit Request Form

Fill out the form below completely.  All receipts/additional documentation should be emailed to cfaorland@gmail.com. 

Supporting Documentation for Redemption

Volunteer Hours 

  • Short paragraph describing volunteer work & your impact 

  • Picture of volunteer experience 

Gym Membership 

  • Proof of gym membership such as receipt or membership charge 

Event Ticket 

  • Proof of ticket purchase listing event name, date, & cost