Microgrant Reimbursement Form

Thank you for applying for a Microgrant!

We hope your event was fun and meaningful. Please use the form below to provide your information for reimbursement.

In order to process your reimbursement check, you will need to provide:

- Attendee List (with age range and optional contact information only for those guests who did not register through the Connect Jewish Tucson platform)

- Photos documenting the event (if Shabbat will prevent you from taking pictures during the event, photos from the setup will be acceptable)

- A brief write-up summarizing the event, and any key takeaways you had as a host

- Receipts from purchases related to the event. Expenses are reimbursable up to $100

Please allow for up to 10 business days to process your check.

Thank you for helping make Southern Arizona a more vibrant place for the Jewish Community!

"*" indicates required fields

Personal details

Please provide a few basic details about yourself.

What is your name?*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Event details

Event title*

Event date*

Number of attendees*

Please include the names (and optionally, email addresses) of any guests who attended who did not regsister through the Connect Jewish Tucson platform*

Briefly describe the event. How did it go? What went well? Is there anything you would change next time?*

Please upload photos from the event

Drop files here or

Accepted file types: jpg, jpeg, png, gif, heic, avif, webp, Max. file size: 7 MB, Max. files: 10.

Please detail your reimbursement eligible expenses (up to $100)*

Please upload your receipts

If you made purchases unrelated to the event during the same transaction, please highlight the items that are event-related.

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, gif, heic, avif, webp, Max. file size: 7 MB, Max. files: 10.

Signature*