Payment Request Form

Use this form to submit payment requests for: Faculty Expense Reimbursements, Honoraria, Student Payments, invoice payments, or 3rd Party Reimbursements


For questions, contact DOFBudgets@pitzer.edu

Budget Management Team

Andrea Harris & Brigitte Garney

Pitzer College | Office of the Dean of Faculty


Faculty Expense Reimbursements:

    Required Information:

  • Itemized receipts with proof of payment
  • If a receipt is lost or missing, a  Missing or Lost Receipt Declaration Form must be completed.
  • Business justification (including names of attendees for meeting meals or entertainment reimbursement)
  • Reimbursement requests must be submitted within 30 days of purchase (Due to IRS requirements, expense reimbursements submitted beyond 60 days become taxable income)
  • Click here to view college expense reimbursement policy
  • Click here to view college travel policy and list of allowable expenses
  • Travel reimbursements can be processed after the trip has occurred. Due two weeks after return from travel please submit travel report Click here hotel folio as applicable, and itemized receipts with proof of payment for airfare, lodging, transportation, and meal receipts. For any travel meeting meals please list meeting meal attendees. For trips with more than 10 receipts, please upload all receipts to Box and share the Box folder with DoF Budget team members.


Honoraria for Speakers

    Required Information for recipient(s):

  • Payee name, address, email address, and phone number
  • Date of presentation
  • Whether the presentation was given in person or via zoom
  • Course/event name (If applicable)
  • Committee funded award letter (if applicable)


Pitzer Students Awards

    Required information for recipient(s):

  • Payee name, address, email address, and phone number
  • Award letter
  • If paying multiple students, attach a list of student names and award amounts.


Invoice Payments

    Required Information for recipient(s):

  • Payee name, address, email address, and phone number
  • Copy of invoice


3rd Party Reimbursements (Excluding Pitzer faculty, staff & students)

    Required Information for recipient(s):

  • Payee name, address, email address, and phone number
  • Invoice or receipt
  • If reimbursing speakers or job candidates for expenses, itemized receipts are required



Payment will be sent via check generally within 30 days of receipt of required materials.


For direct wire transfer rather than check, click here to complete this form.

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Specify type of payment requested

Name of person to be paid

Address of person to be paid

Email address of person to be paid

Phone number of person to be paid

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  • Enter the name of the Field Group/Endowed Professorship/Program/Gift to identify which budget to use.
  • If dividing expense between multiple budgets, list each budget and amount to charge to each.

Please specify Dean of Faculty budget type. Select from dropdown or type your answer below.

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If applicable, list attendees

Please provide information about the event including: Event name or course name (if applicable), date of presentation, and if the presentation was given in person or via Zoom.

Optional: add any other pertinent information

Student Award Notice:

If paying a student due to an award received, please attach a copy of the award in the "attachments" section below.


If paying multiple students, please attach a list of names, award amounts, and award letters for each student in the attachment section below.

Notice to be reimbursed for class snacks:

Please include name of class and class roster in the attachments below to be reimbursed for class snacks (maximum $50 per class)

Please attach invoices, receipts, award letters, flyer for speaker, etc. and all other payment supporting documentation, as needed. File format- PDF, JPEG.

Drag and drop files here or