CIC Travel Reimbursement Form

CIC Travel Reimbursement Form
Traveler's Name*
Traveler's Email Address*
example@example.com
Traveler's Department*

CICiSchoolSJMCSIPA
Please upload your approved travel request form

Cancelof
Accounting information for reimbursement
Departure date and time*

MonthDayYear
Hour MinutesAM/PM Option
Return date and time*

MonthDayYear
Hour MinutesAM/PM Option
Destination*
City, State, Country
Did you travel internationally?*

YesNo
Please select all types of expenses that were incurred during travel. Please do not include an expense if it was direct billed to the college or school.*

AirfareLodgingMeal expensesGas mileageRegistration feesLuggage feesGround transportation (Taxi, Uber, etc.)Other travel expenses
Airfare
Total airfare*
Please upload a copy of your flight receipt*

Cancelof
Lodging
Total lodging*
Please upload a copy of your itemized lodging receipt*

Cancelof
Meal Expenses
Please use the table below to calculate your total meals per diem during travel. Non-departure or return travel days receive the full $35 in state/$50 out of state per diem.
Please use this link to calculate total meals per diem during travel
Were any meals included as part of your trip/registration?*

YesNo
Please list any meals that were included*
Ex: Dinner, 1/1/22; Lunch 1/2/22
Please upload copies of your meal expense receipts (if applicable)

Cancelof
Total meal expenses*
Mileage
Total miles traveled*
Total mileage reimbursement amount
Please upload a screenshot of your route from Google Maps*

Cancelof
Total mileage reimbursement amount*
Registration
Total registration fees*
Please upload a copy of your registration receipt*

Cancelof
Luggage
Total luggage fees*
Please upload a copy of your luggage fee receipts*

Cancelof
Ground Transportation
Total ground transportation expenses*
Please upload a copy of your ground transportation receipts*

Cancelof
Other Expenses
Total other expenses*
Please upload a copy of your receipts for other expenses*

Cancelof
Please include a brief description of other expenses*
TOTAL
Total travel expenses
Total travel expenses*
Should be Empty:

CIC Travel Reimbursement Form

Airfare

Lodging

Meal Expenses

Mileage

Registration

Luggage

Ground Transportation

Other Expenses

TOTAL