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Online Travel Reimbursement Form

Complete the below form, attach relevant documentation for expenses (you may use the Upload tool at the bottom) and click “Submit” to request reimbursement. You may also download this form in PDF using the “Downloadable Form” link on the right and complete and submit per the instructions on that form For help, refer to the Travel Reimbursement Policy link on the right.
Meeting Location


Reimbursable Expenses


(Basic Economy/Coach rate)
(Coach Rate)
mi. x IRS mileage rate ($0.545 to 12/31/18)

Lodging Costs

(not to exceed $300 excluding tax, attach bill)

Meals & Incidentals 

(not to exceed $64, attach receipts for items over $25)

Limits: Individual reimbursement requests are limited to $800 in total per request and members are limited to a cumulative amount of approved reimbursement requests of $4,000 per Society fiscal year (6/1-5/31).

See part h. of the Travel Reimbursement Policy for details and exceptions.

DEPARTMENT EXP: __________________________________________________________

APPROVAL: _________________________________________________________________

 ►Please include scanned receipts or other substantiation for transportation and out-of pocket expenses over $25. You may use the Upload tool below.

►Reimbursement requests must be received within six months of the meeting date or reimbursement will be denied.

Have my reimbursement check made payable and mailed to:

(please print or type)

Upload Receipts

Upload Receipts

By submitting this form you affirm that the information provided is true and correct.