Ed Advocacy Grant Reimbursement Form

Please provide the following information when requesting reimbursement. Upload receipts for reimbursement as well as attendee lists and related items.

Name

First Last

Cell Phone

Local Association

Event Name

Event Date

Please Provide a Brief Description of the Event, Including Your Results

Please list the names of those who took a membership form from your event, so we can link them to your event when they sign up as a WEAC-Retired member.

Expense Categories

Complete the expense categories related to your reimbursement.

Total Miles

How many total miles did you travel?

Mileage Amount (@ $.70)

Lodging Description

Lodging Amount

How much did you spend on lodging?

Meals Description

Meals Amount

How much did you spend on food and beverages, including tips and any catering costs?

Printing Description

Printing Amount

How much did you spend on printing – flyers, handouts, brochures, signs, other?

Postage Description

Postage Amount

How much did you spend on postage?

Supplies Description

Supplies Amount

How much did you spend on materials for the event- pens, name tags, decor, gift cards, door prizes, other?

Outside Services Description

Did you pay companies to provide additional services-buses, music, technology, chair/ supply rentals, other?

Outside Services Amount

What is the total amount you paid for outside services?

Other Expense Description

Other Expense Amount

Total Reimbursement

Name of Payee (individual or organization receiving reimbursement)

Payee's Mailing Address

Upload Documentation

Upload any attendance lists, event materials/fliers and any receipts for which you are seeking reimbursement as one .pdf file. Multiple documents will not transmit successfully.

Max. file size: 50 MB.