Representative Name
Representative Email
Territory
Date of Request
Date of Lunch/Event
Time of Lunch/Event
Facility / Account Name
Location / Restaurant
Contact Person(s) Attending
Purpose of Lunch Meeting Relationship BuildingNew Business DevelopmentCase ReviewEducational PresentationFollow-Up Visit
Other (purpose)
Estimated Number of Attendees
Estimated Total Cost ($)
Expected Business Outcome
Representative Signature (type full name)
Date
Manager Approval
Approved Amount ($)
Date Approved
Note: Manager Approval, Approved Amount, and Date Approved are completed by your manager after submission. You do not need to fill these in — they will be added during the approval review.
Please submit the following within 48 hours of the lunch:
✓ Itemized Receipt Attached ✓ List of Attendees Provided ✓ Meeting Notes/Outcome Submitted ✓ Expense Report Completed
Failure to provide required documentation may result in denial of reimbursement.
