DLII Grant Reimbursement Worksheet

DLII Grant Reimbursement Worksheet

Upon completion of using the grant funds, please complete this worksheet for reimbursement via IDT to your college/department. You can't be reimbursed until after you have completed your travel, purchase, or guest speaker presentation.

Date Submitted

Faculty Member*

Faculty Email*

Campus Address*

Office Professional Name*

Office Professional Email*

OP's Phone*

Award Information*

Select

Award Amount*

Reimbursement Information

Budget Number*

Funds will be reimbursed to your department via the appropriate budget forms.

Name of School/Department

Support Documentation*

Please include copies of all paperwork used to support this request:

ChromeRiver report (Travel expenses/BPC expenses)
Purchase Order (Equipment purchases/supply purchases)
Payment Request (Conference Registration/Speaker Honorarium/Speaker hotel or misc expenses)

Drag and drop files here or

Name of individual completing reimbursement form *

Verify signature*

By verifying your signature, you agree that you are submitting accurate and complete information.

Send me a copy of my responses

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