ITEMIZED ESTIMATED EXPENSES
Original receipts and proof of payment in the applicant’s name are required for reimbursement of
approved expenses. Sharing hotel expenses? Each attendee must pay for their own portion of the hotel bill
and have a receipt issued in their name.
Conference/Seminar Fee: $
[Maximum $500 for one-day activities less than 150 miles away from the
work site, or less than 75 miles away for multiple-day events; maximum
$1000 for one-day activities more than 150 miles away from the work site,
or over 75 miles away for multiple-day events]
Transportation: Airfare OR Mileage $
[For events you are driving to indicate which is closer to the event:
your residence: or your worksite
Enter the round-trip miles from home/work to the event: ;
Enter the number of days you will be travelling to the event: .
Reimbursement amount: round-trip miles x # of trips x $0.555/mile = ]
Ground Transportation
[Include public transit, round trip shuttle or taxi expenses from airport
to hotel, or car rental, where applicable] $
For local events, the committee recommends using public
transportation where possible.
Meals for All Days of the Activity $
[Maximums per day: Breakfast - $10, Lunch - $15, Dinner - $30.
Actual receipts do not need to be turned in. Meals provided by the
conference as part of the conference fee are not reimbursable. Meals
must be paid for by attendee; District ProCards may not be used for meals.]
Lodging $
# of nights @ $ per night (include estimated taxes) =
[Only for activities 75 miles or more away from the college.]
Total Costs: $
AMOUNT REQUESTED: $
The committee strongly recommends that the applicant and manager discuss in advance
how the time away from the workplace for this activity will be reflected on the applicant’s
timesheet, if at all.
Please identify any additional District funding that you will be using for this activity (i.e. college grants,
VTEA funds, Impact/AAPI, B Budget, etc.), as they must be submitted on the same trip voucher
(name of fund/amount approved):
Signature of Applicant:
Signature of Supervisor: Date:
I certify that this applicant is not probationary and not on Staff Development Leave.
Comments:
