WI OFFICIALS TRAVEL REIMBURSEMENT REQUEST

WI OFFICIALS TRAVEL FUND APPLICATION
This is an application to receive funds for travel expenses incurred while officiating at an upper level meet or for traveling more than 200 miles one-way to a WI LSC State Championship meet. Please click here for details on the reimbursement program.

General rules
- Officials working a qualifying meet may not receive more than their actual expenses in travel assistance from USA Swimming and Wisconsin Swimming combined.
- An official may receive up to two (2) travel travel expense reimbursements in each competition year, only one of which can be for Futures level and above meets.
- When the yearly allocation is exhausted no additional allocations will be made for meets held in that competition year.
- Reimbursement is designed to cover travel and lodging expenses, such as miles or airfare and hotel.
- In order to receive travel assistance from Wisconsin Swimming, an official must meet certain minimum eligibility requirements
Please complete 1 Reimbursement Request per meet.

Please do not use this form for State Meet Assigned Officials Team.

Please attach a copy of your receipt (s). This request will NOT be processed without it.

Direct any questions to FinanceManager@wisconsinswimming.org or OfficialsChair@wisconsinswimming.org

OFFICIALS and MEET INFO
NAME
ADDRESS
Street address, City, State, Zip
EMAIL*
example@example.com
Phone Number
Please enter a valid phone number.
HIGHEST LEVEL OF CERTIFICATION
Type of Meet*
NAME OF MEET*
LOCATION OF MEET*
MEET DATE - Start

MonthDayYear
Date
MEET DATE - End

MonthDayYear
Date
NUMBER OF SESSIONS YOU WORKED
NUMBER OF SESSIONS IN THE MEET
INCLUDE TIME TRIALS IN THE TOTAL
AMOUNT OF REIMBURSEMENT REQUESTED*
Is this your first application for funds in the current fiscal year? (Sep1 - Aug 31)*

YesNo
If you have previously applied for funds, please specify the meet info and date of your previous application for reimbursement.
UPLOAD Receipt(s)*

Cancelof
WISCONSIN SWIMMING OFFICIALS TRAVEL REIMBURSEMENT PROGRAM:

Different reimbursement levels are available for different meets (see below). Officials are eligible for up to two (2) travel expense reimbursement every year, based on a first-come-first serve basis. Once all applications for one travel expense reimbursement per budget year have been paid out, applications for a second travel expense reimbursement will be considered as long as funds are available.
- Zone and Sectional Meets up to $ 500 (with the exception of any Open Water Championship meets held in WI, for which the maximum reimbursement is $150)
- Futures and Pro Meets up to $ 600
- Junior National and National Meets up to $700
- Officials traveling more than 200 miles one-way to a Wisconsin LSC State Championship meet - $150
Please read the Program details here for additional information and eligibility requirements.
Acknowledgement*

I acknowledge that I have read and understand the Wisconsin Swimming Officials National Meet Education Reimbursement Program. I confirm I have met eligibility requirements and have submitted the applicable documentation needed for reimbursement
Initials blanks*
Date

MonthDayYear
Date
Should be Empty:

WI OFFICIALS TRAVEL FUND APPLICATION

OFFICIALS and MEET INFO