Travel Reimbursement Form

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Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Select Campus(Required)

Campus Contact Email(Required)

This is the person who will receive your form responses and receipts (likely the person completing the reimbursement on your behalf).

Enter Email Confirm Email

Reimbursement Type(Required)

Conference

Research

Interview

Non-Travel

Other

Are you a student?(Required)

Yes

Is your travel/purchase part of a student org?(Required)

Yes

Trip Start Date(Required)

Trip End Date(Required)

Conference Name(Required)

If the name is an acronym, please write the full name. (Ex. NCUR = National Conference on Undergraduate Research)

Please upload supporting documentation for your travel.(Required)

(Agendas, itinerary, etc. Please do not upload receipts.)

Drop files here or

Max. file size: 20 MB.

Describe your research and any related travel.(Required)

Expenses(Required)

Please select the expenses you paid for out-of-pocket.

Per Diem Meals

Personal Vehicle/Mileage

Hotel/Lodging/Airbnb

Registration Fee

Car Rental

Car Rental Fuel

Parking

Airfare

Agency Service Fees

Baggage

Ride Share (Uber/Lyft/Taxi)

Shuttle

Bus/Train

Supplies (Non-Travel)

Other

Per Diem Meals

Per Diem Meals Provided

Please list all meals provided to you during travel (i.e. the meals you did not pay for out-of-pocket). Options: Breakfast, Lunch, Dinner

Mileage

Starting Address

Street Address Address Line 2 City State ZIP Code

Destination Address

Street Address Address Line 2 City State ZIP Code

Round Trip?

Yes

Additional Info (Optional)

Additional Mileage Line1

Add Additional Mileage?

Yes

Starting Address

Street Address Address Line 2 City State ZIP Code

Destination Address

Street Address Address Line 2 City State ZIP Code

Round Trip?

Yes

Additional Info (Optional)

Additional Mileage Line2

Add Additional Mileage?

Yes

Starting Address

Street Address Address Line 2 City State ZIP Code

Destination Address

Street Address Address Line 2 City State ZIP Code

Round Trip?

Yes

Additional Info (Optional)

Additional Mileage Line3

Add Additional Mileage?

Yes

Starting Address

Street Address Address Line 2 City State ZIP Code

Destination Address

Street Address Address Line 2 City State ZIP Code

Round Trip?

Yes

Additional Info (Optional)

Lodging

Lodging Cost(Required)

Number of Nights(Required)

Merchant

Additional Travelers / Info

Please list the names of any other travelers who stayed in the this hotel. Please list the names by hotel room if applicable. Include any additional information such as one person paid for multiple rooms, etc.

Receipt(Required)

Please upload the hotel receipt.

Drop files here or

Max. file size: 20 MB.

Car Rental

Car Rental Total Cost(Required)

Additional Info (optional)

Include any additional info that may be helpful.

Car Rental Receipt(Required)

Drop files here or

Max. file size: 20 MB.

Fuel Costs(Required)

Please list all your fuel transactions including date and the merchant. (Ex. 5/03/26 Kwik Trip $32.45)

Fuel Receipts

Upload receipts over $50.

Drop files here or

Max. file size: 20 MB.

Parking

Parking Costs(Required)

Please list the expense date, parking costs and the location. (Ex. 6/25/26 Airport Parking $55.89; 7/15/26 Campus Parking $12)

Parking Receipts

Upload receipts over $50.

Drop files here or

Max. file size: 20 MB.

Other Costs(Required)

Please list any other costs including expense date and a brief description.

Other Receipts

Upload receipts over $50.

Drop files here or

Max. file size: 20 MB.

Additional Information/Comments (Optional)

Please include any additional information that may be helpful for your campus contact to process your reimbursement.