Inter Faculty Organization Expense Reimbursement Form

Please submit all receipts by email to Donna Blake at blake@ifo.org. 

Name *
Name
this is your electronic signature
Mailing Address *
Mailing Address
Where would you like us to send your reimbursement check?
What did you meet for?
Where did you meet?
Meeting Date *
Meeting Date
airfare, taxi, bus, train
# miles x $.535
$10 per diem, up to $20 with receipt
$12 per diem, up to $24 with receipt
$20 per diem, up to $50 with receipt
Please identify
By checking the box below I certify that this is an accurate statement of my expenses. *