Income & Expense Form
Wisconsin Music Teachers Association
Submitted by
*
Email
*
Activity
*
WMTA District Auditions
WMTA Regional Competition
WMTA State Competition
MTNA Competitions
Young Composer Festival
State Conference
Grant / Award
Membership
Advertising
Administration
District
General / All
Appleton
Eau Claire
Kenosha
La Crosse
Madison
Merrill
Milwaukee
Oshkosh
River Falls
Sheboygan
Stevens Point
Superior
Wausau
Whitewater
Site
General / All
Northeast
Northwest
South
Track
Keyboard
Vocal, Instrumental, Ensemble
Category
*
EXPENSE - Reimbursement request
EXPENSE - Invoice, grant, or award to be paid
EXPENSE - Contractor to be paid (judge, presenter, etc.)
INCOME
Reimbursement
Reimbursement
Expenses must be submitted within 90 days to be eligible for reimbursement.
Mileage
$0.50/mile (400-mile max)
Lodging
$85 max
Chair Stipend
$0.50/entry
Other Expenses
$
Description
1
2
3
4
5
6
7
8
9
10
TOTAL
Invoice, Grant, Award
Invoice, Grant, Award
Please submit a separate form for each recipient.
Recipient / Vendor
Description
Amount
Contractors
Judge, Presenter, Contractor
Please submit a separate form for each individual.
Name
Email
Rate
Ex: $35
Hours / Units worked
Ex: 5
TOTAL WAGES
Mileage
$0.50/mile (400-mile max)
Lodging
$85 max
TOTAL EXPENSES
TOTAL PAY
Income
Please list each item:
All
Please attach all documentation
Upload Files
Receipt, invoice, contract, report, etc.
Cancel
of
Send check to:
Street
Apt
City
State
Zip
Notes
Submit
Should be Empty: