Metropolitan Swimming Officials' Travel Expense Reimbursement

Metropolitan Swimming Officials' Travel Expense Reimbursement

Officials' Travel Assistance
I am requesting reimbursement for the following meet:*
Dates of Meet:*
Official's Name*

First NameLast Name
Address where reimbursement should be sent to:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Current LSC Certifications:

Stroke and TurnStarterRefereeAdmin Referee
Current National Certifications:

Stroke & TurnChief JudgeStarterRefereeN-2 StarterN-3 StarterN-2 RefereeN-3 Referee
Position(s) worked at meet:
National Certification applied for:
Have you received travel support from Metro in the preceding 12 months*

YesNo
If so, for what meet and how much $
Have you received any compensation from any Metro club for officiating?*

YesNo
If so, for what club and how much $
How many sessions of Sr. Mets' have you worked in the past 14 months*
Proof of travel related expenses to the meet must be uploaded to this form

LIST OF APPROVED DOCUMENTS FOR PROOF OF TRAVEL EXPENSES FOR

CHAMPIONSHIP MEET TRAVEL REIMBURSEMENT

Hotel receipts from venue area / city and within date range of the meet

Receipts or ticket stubs for air fare, train or bus to / from city of meet venue

Mileage – include a map quest or similar travel program to support mileage from official’s home to city of meet venue. Mileage will be reimbursed at IRS federally approved mileage rate. Please list any toll related expense.

Meal receipts (meal expense up to $25 per day will not require a receipt)

The requirement for proof of travel expense is to protect Metropolitan Swimming Inc. and the Officials receiving the travel reimbursement

Expenses*

	Amount
Hotel Total
Transportation Total
Mileage Total
Meals Total
Other Total
Final Total (Automatically Calculated)

Other:
Signature of requesting official:*

Clear
Date*

MonthDayYear
Date

All expenses and forms must be received no later than 30 days after the last day of the meet.

RATES OF REIMBURSEMENT:

Zone Meet	up to $200.00
Sectional Meet	up to $200.00
NCSA Jr's	up to $200.00
TYR Pro Series	up to $400.00
Futures	up to $400.00
Jr. Nationals	up to $500.00
Sr.Nationals/Open	up to $500.00
Open Water Nationals	up to $500.00

Documentation upload*

Browse Files
You can submit multiple files by holding control key on windows or command key on a mac Cancelof
Email
example@example.com
Should be Empty: