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 LQGLFDWHZKLFKLVFORVHUWRWKHHYHQW
\RXUUHVLGHQFHRU\RXUZRUNVLWH
(nter the round-trip milesIURPKRPHZRUNWRWKHHYHQW: ;
(nter the number of days you will be driving back and forth to the event: .
5eimbursementDPRXQW: round-trip miles x # of WULSV x $0.5/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: $
Please identify any additional funding that you will be using for this activity (college grants, VTEA, B Budget,
personal funds, etc.)
Fund Index Code Fund Description Amount Mgr’s Initials
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.
Signature of Applicant:
I understand that, unless approved at the time of this application, other college funding will not be
available for this activity, and all expenses must be submitted on one trip voucher.
Signature of Supervisor: Date:
I certify that this applicant is not probationary and not on Staff Development Leave.
Comments:
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