In the name of Allah, the Most Merciful, Most Gracious

Al-Fatiha Foundation Tel. 202-452-5534

P.O. Box 33015 Email: gaymuslims@yahoo.com
Washington, DC 20033 Web: http://www.al-fatiha.org

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http://groups.yahoo.com/group/al-fatiha-news

Al-Fatiha Expense Report

Instructions: Please use one form per expense (e.g. conference, event, travel, etc). Be as detailed as possible and itemize
expenses. Please attach receipts or any proof of purchase. Allow up to 3 weeks to receive payment.

Date:

Name:
Address:
City: State: Zip Code:

Telephone #:
Email:

Check payable to:

Amount of Check:

Date(s) of Event:
Location(s) of Event:

Description of Event / Itemization of Expense(s):

Please mail this form and receipt(s) to: Al-Fatiha Foundation

Expense Report
PO Box 33532
Washington, DC 20033

For Al-Fatiha Internal Use Only:

Check #: Check sent by:

Check signed by: Entered into database?

June 2004 Copyright Al-Fatiha Foundation. This document cannot be changed or altered without approval of the board of directors.

Al-Fatiha Dedicated to Supporting and Empowering Lesbian, Gay, Bisexual, Transgender, Intersex, Questioning (LGBTIQ) Muslims and their Allies