| This
form is used to request reimbursement for HSPG recipients.
Save the appropriate document
to your computer. Please note that some versions of Internet Explorer may have
difficulties downloading Word documents. If this should occur, try using Netscape
instead.
For Windows:
Word 97 and higher:
HSPG
Reimbursement Form
For Other Platforms
(PDF):
HSPG
Reimbursement Form
Portable Document Files (PDF) require Adobe
Acrobat Reader to be installed on your computer. Adobe Access provides a set
of free tools that allow visually disabled users to read documents in PDF format.
Go to http://access.adobe.com/simple_form
and type the URL of this PDF document into the electronic form.
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