Student Org Reimbursement Request (Non-Employee)

Student Org Reimbursement Request (Non-Employee)
This Reimbursement Request form is required when the requester does NOT have a MICA Workday account (i.e. is not and never has been employed by MICA). If you are a student employee, you should use this form instead.

Student organizations who wish to be reimbursed for purchases must adhere to the policies and procedures outlined below. These are specific to student organizations. Please note that reimbursement requests submitted for other departments may have different requirements.

Reimbursement Policies
1. Reimbursements should be used as a last resort for student organizations whenever possible. With proper planning, student organizations can typically utilize other resources to avoid spending out-of-pocket. Review the Student Organization Handbook for more information.
2. The following items are NOT reimbursable under any circumstances:
  - Gift cards
  - Gas (can request a mileage reimbursement instead)
  - Branded clothing/apparel for organization members
3. All reimbursements require documentation of purchase in the form of an itemized receipt, with the exception of mileage reimbursements (which require documentation in the form of Google Map directions showing the start and end location, along with the total miles). The following are REQUIRED of all receipts:
  - Receipts must be legible
  - Receipts must be itemized (i.e. show each item/quantity purchased, price per item, and total)
  - Receipts must include the date of purchase
  - Receipts must show proof of purchase
4. Student organizations must submit the appropriate Student Organization Reimbursement Request form, which is dependent upon whether or not the requester has a MICA Workday account (i.e. is or has been employed by MICA).
5. In addition to the policies noted above, student organizations must adhere to MICA's Business and Travel Expense Policy.
When possible, student organizations should inform the Student Involvement Specialist that they will be requesting a reimbursement before purchasing. Reimbursements will only be approved if the purchases align with the student organizations goals and mission statement.

If this is your first time submitting a reimbursement request, you must also include a completed W9 form (or W8-BEN, if you are an international student) with your Reimbursement Form.
Who is filling out this form*
Full Name*
Email*
example@example.com
Student Organization*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Department

Receipt #1
Date
Date

YearMonthDay
Date
MMYY Calculation
Account-fund-department
Cost Center
Additional Worktag
studentorgs@mica.edu
example@example.com
Please indicate what this purchase was for.*
Select the most appropriate option from the dropdown.
Event / Activity Name (if applicable)
EXAMPLE: "ASA Meeting on 10/15/19" or "Burlesque Little Show" or "BSU Cookout"
Date of Purchase*

MonthDayYear
Purchase Description / Purpose*
Briefly describe the purpose of this purchase. Example: Snacks for BSU meeting; Supplies for print making workshop; Mileage for camping trip transportation
Total Mileage*
Please provide the total number of miles traveled.
Mileage Calculation
Amount*
Receipt/Mileage Documentation*

The following is REQUIRED of all receipt submissions in order to be processed: Receipts must be legible, itemized (i.e. show each item/quantity purchased, price per item, and total), include the date of purchase, and show proof of purchase.
Cancelof
Today's Date*

MonthDayYear
Date
Signature

Clear
Should be Empty: