After Conference/Program Report

All awardees are expected to complete the after-conference report section (Part 1) once you have attended the conference/program.

If you filed an application for reimbursement prior to attending the conference, please complete the OSA Reimbursement Request Form (Part 2). If you are requesting a reimbursement BE SURE that you attach all original reciepts to the form and send by snail mail (US Post) only to:

OSA - C/O Anderson
4836 SW Scholls Ferry Rd #193
Portland, OR 97225-1667

After the Conference/Program Report

User name:

First name:

Last name:

Email: *

Mailing Address:

City:

State:

Zip:

I attended the conference/program for which I received funding:

yes

Training Class:

Dates Attended:

Phone: *

Outcome #1:

Outcome #2:

Outcome #3:

Part Two

Any qualified individual can submit a request for reimbursement of up to ½ of their total expenses. The amount requested, however, may not exceed $750. Use an extra sheet if needed.
IMPORTANT: You must provide original applicable receipts:

Hotel folio.
Airfare (if applicable), Car rental and contract, fuel and parking receipts.
Individual meal receipts (hotel meal claims must be accompanied by the actual receipt for that meal).
Actual mileage if driving your own vehicle. Mileage is to be calculated at $ 0.55/mile
Any other receipts for which reimbursement is requested.

Amount more than $750:

execdirector@oregonsim.org.-Attach-a-copy-of-that-explanation-to-this-paperwork.

-wrapper">

I wish to be considered for an amount greater than the $750 limit and I have submitted a one page explanation summary to execdirector@oregonsim.org. Attach a copy of that explanation to this paperwork.

Worksheet: Inventory List of Original, Applicable Receipts Use an extra page if necessary. Refer to list of original receipts for descriptions.

Work sheet: *

Include Date, Description of Expense and Amount of Expense.

Total Expenses (Add all lines) A:

Divide line (A) by 2 & enter that amount of $750 (which is less) B:

Employer Contribution (B minus A above):

Total Expenses (from A above):

Amount:

Amount to be reimbursed to individual (enter amount from line B above)

Comments:

Participant's Notes/Comments

Search

Oregon Simulation Alliance

After Conference/Program Report