Clay Grant Report and Reimbursement

Clay Grant Report and Reimbursement Form
To receive a reimbursement for your Clay Grant program, complete this form and attach PDF copies of receipts for actual expenses accrued.  If you have any questions about the reimbursement process, contact Mary Burner ( or 540458-5347). DEADLINE FOR REIMBURSEMENTS: November 30, 2016
Provide a 100-word brief description of the program and outcomes that would be suitable for social media (ODK website, Facebook, Instagram, etc.).
In 1000 words or less, provide a detailed description of the activities and outcome of the final program. These reports may be used for ODK publications so please be as detailed as possible. If you have photos of your program, please send directly to Dr. Tim Reed,
Please note: Clay grants are awarded for actual expenses up to $500. If you are claiming less than $500, you will only be reimbursed the amount you claim based on your original proposal and submitted receipts. If your expenses were more than $500, please provide the actual amount incurred for our documentation.
Please insert the specific name of the institution or individual to whom the payment should be addressed. If this is a circle private bank account, it is helpful if you attach a voided check or deposit ticket so we can include that account number on the check.
Please attach PDF copies of all receipts related to your program. The total amount of these receipts should equal your request.
Please provide photos. You can also send photos to