Faculty Expense Reimbursement & Honorarium Form

Faculty Expense Reimbursement Form 2025

We can not make honorarium payment to faculty who are not US citizens or permanent residents. Individuals on non-immigrant visas are not eligible to receive payment from businesses other than their employers or sponsors of the visa. Please complete this form and attach all original receipts. If honorarium is provided and you are opting to receive honorarium, please also include your most updated form W9 signed within the last one year and a voided check for ACH payment to ensure you receive the payments in a timely manner.
Due to accounting and reconciliation compliance requirements, we request that you submit your expense and honorarium request within 10-days of the conference.

If we do not receive an honorarium or reimbursement request within 60-days of the conference, we will assume that you wish to donate the expenses and the honoraria to Binaytara. We will send a donation receipt after 61-days. Once the receipt has been sent, we will no longer process the honorarium or reimbursement request.
Faculty Name*

First NameLast Name
Faculty First Name
Faculty Last Name
Email*
example@example.com
Your role in this conference*
If you participated in more than one role, please include the role with highest amount of time commitment required. If you are completing this form for multiple conferences, please select " I participated in multiple conferences" and list all conferences below
Conference(s) Name(s) & Cities*
If you have more than one conference, please add names & cities of all
Date of participation/presentation*

MonthDayYear
Date
2nd Binaytara conference (if any)

MonthDayYear
Date
3rd Binaytara conference (if any)

MonthDayYear
Date

Information Regarding Expense Reimbursement

In general, travel expenses incurred by faculty for their participation as a speaker/panelist at Binaytara Foundation conferences are reimbursable. However, expenses incurred by faculty for accompanying family members are not reimbursable. Also, certain meals and travel expenses are not reimbursable. Please find below the list of items we reimburse and those we do not reimburse conference faculty.

Reimbursable

Not reimbursable

Airfare - Reimbursable expenses

Coach class round-trip from/to a domestic airports.

Airfare - Non-reimbursable expenses

Business/first/premium class fare,
Any upgrades,
Luggage check-in fees
International fare
In-flight wifi

Ground transportation - Reimbursable expenses

Rideshare,
Hotel shuttles,
mileage if driving personal vehicle,
parking at the airport/hotel, and
public transportation (train/tram).

We may occasionally reimburse taxi fare but we recommend Uber/Lyft when available.

If there is a shuttle service provided by the hotel to/from the airport (free or paid) ground transportation to/from the hotel is not reimbursable.

Tips upto 15%

Ground transportation - Non-reimbursable expenses

Rental car
Ride for family members or guests of faculty
Gas (please request mileage reimbursement if using pesonal vehicle)
Any other form of transportation not listed on "reimbursed" list
Ground transportation to/from the venue if it offers free or paid shuttle service to the airport.
In-city transporation if the conference provides on-site lodging or lodging within 10-minute walk of the conference venue. (This applies even if faculty chose to stay at a different hotel - no in-city transportation (Taxi, Uber, etc.) reimbursement for faculty who stay at a venue not offered by the conference.)
Tips over 15%

Meal - Reimbursable expenses:

Upto $100 per day (including tips) for upto 2 days in meal expenses are reimbursable when meals are NOT offered to faculty on-site. If the meal is offered on-site (breakfast, lunch, dinner) - reimbursement is not provided for those meals unless faculty's travel schedule does not allow them to be on-site during the meal hours.

Tips upto 15% (within the allowable total)

Meal - Non-reimbursable expenses

Meal reimbursement is not provided for meal expenses incurred by faculty for family members, guests, other conference attendees, etc.
Please submit only the amounts for your meal.
No reimbursement for alcohol
No reimbursement without an itemized receipt. Credit card in lieu of an itemized receipt is not accepted.
Meal expenses when the meal was provided to faculty on-site is not reimbursable. For example: if there is a faculty dinner on a certain date and faculty chooses to dine elsewhere, expenses for dinner on that date is not reimbursed unless faculy's travel schedule doesn't allow them to attend the faculty dinner. Similarly, if the meal is provided on-site during the conference, those expenses are not reimbursable.
Tips over 15%

Lodging - Reimbursable expenses:

Binaytara Foundation reimburses faculty for upto two nights (the night before your talk/session, and the night of your talk/session) at the hotel contracted by the conference. The lodging costs as well as asscoiated mandatory taxes and fees are prepaid by BTF.

Lodging - Non-reimbursable expenses

Lodging for family members or accompanying guests
Air B & B
Room at a hotel not contracted by the conference
Suite upgrades
Pet fee, extra beds, additional amenities
Spa, gift shop, personal expenses
Room service for accompanying guests or faculty
Wifi/gratuity not included in the room plan

Do you have expenses associated with your participation in this conference that you would like the BTF to reimburse?*

No, all expenses were pre-paidNo, I will cover the expenses, send me a donation receipt for the amounts (see expense details below)Yes, I would like reimbursement for the following expenses (see expense details below)
Expense Details
Please upload receipts

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Total Donation Amount (if you wish to donate any portion of the expense to help to build the cancer hospital)
Please list any travel expense amounts you wish to donate instead of being reimbursed. The Binaytara Foundation is a 501(c)3 non-profit organization. Donations to the Binaytara Foundation are tax-deductible to the extent permitted by law. Donation is voluntary. Faculty are not required to donate the expenses or honoraria to the Binaytara Foundation.
Honorarium Amounts by Faculty Role - 2025
If you participated in more than one role, you will receive honorarium for the role with the highest amount of honorarium. For example: If you are a conference chair and also moderated a session, presented on a topic, presented a case, or served on a panel, you will receive honorarium for the conference chair role but no additional honorarium for serving on panel or giving a presentation. Similarly, if you are a topic presenter who also moderated a session or participated as a panelist, you will receive honorarium for the topic presenter role but no additional honoraria for participating in the panel or presenting a case.
If an honorarium is provided (please select an option from below). Please note that we no longer pay reimbursement or honorarium with a check. All payments will be made by Direct Deposits only*

I will donate my honorarium to BTF to support the Cancer Hospital in NepalSend me the full amount of honorarium via direct deposit. I am a US Citizen or permanent resident eligible to receive compensation from Binaytara.Other
Direct desposits are processed weekly on Wednesdays. Reimbursement and honorarium requests received by Friday are processed the next Wednesday.

We make every efforts to process reimbursements and honoraria in time. However, factors such as incomplete Form W9 (only required if you are accepting honorarium), incorrect bank details, etc. delay the processing.

Please note that:
- We are unable donate the honorarium to another organization on your behalf.
- We can not pay another entity or individual for services provided by you. The form W9 and bank account should match the faculty name.
- We are unable to pay honorarium or reimbursements in the form of a gift card.
- We are required by law to report the honorarium payments to the IRS. We issue a form 1099 at the year end to all recipients who meet the threshold.
Please upload your completed form W9 (March 2024 version)*

Browse Files
The IRS updated the form W9 in March 2024. We require the latest version of the W9 for honorarium payment. Please download the blank form W9 here - https://www.irs.gov/pub/irs-pdf/fw9.pdf Cancelof
Please upload a voided check to send your ACH payment*

Browse Files

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Where should we mail the donation receipt to?*

Street Address

Street Address Line 2

CityState

Zip Code
By signing below, I attest that I am a US citizen or permanent resident eligible to receive compensation from Binaytara. The tax ID I provided in the attached W9 is registered to me. I am aware that Binaytara does not compensate an entity or another individual for services provided by me unless a written agreement exists between Binaytara and the entity for my services, and I have consented in writing to such payment arrangement.

Clear
Any additional instructions?
Please type if you have any additional instructions such as the check to be made payable to a different person than you.
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Faculty Expense Reimbursement Form 2025

Information Regarding Expense Reimbursement