NEOEA	North Eastern Ohio Education Association
NEOEA Day: Friday, October 10, 2025	
 Program Expense Claim Form
If you are not receiving NEOEA funding, please ignore this form. Postmark by Friday, October 24, 2025, and return with your final report.

Program title:	Program number:	
Chairperson:	
Address:

	

Please note:
•	If a check is $600 or above, you must provide the payee’s Social Security Number or Tax Identification Number and mailing address.
•	Please enclose receipts or other documentation of expenses.

Payee:

Address:

	
			
	Street	City, State	ZIP	
Amount:
	
	Recipient’s SSN or TIN (if required)		

Payee:
		
Address:

	Street	City, State	ZIP	
Amount:	
	Recipient’s SSN (if required):		

Total amount requested: $____________ (may not exceed the total NEOEA grant).

North Eastern Ohio Education Association
6001 Landerhaven Drive, Suite D, Mayfield Hts., OH  44124-4190
216.518.0200     desk@neoea.org