Attendance Expense Reimbursement Request If you did not stay to the Host Hotel or approved location set by the ICES Board of Directors, you are not eligible for Attendance Reimbursement. Your InformationSelect Position:*Please Select OneBoard MemberExpo CoordinatorOtherName* First Last Phone*Alt PhoneEmail* Enter Email Confirm Email Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If "Other"* Hotel InformationDid you stay at the Host Hotel* Yes No If you did not stay to the Host Hotel or approved location set by the ICES Board of Directors, you are not eligible for Attendance Reimbursement. Name of Hotel* Hotel Receipt 1* Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. Hotel Points do not count towards your Financial Reimbursement. You may upload 6 separate files in each Hotel Receipt field.Hotel Receipt 2 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 6 MB. Hotel Receipt 3 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. Hotel Cost*Transportation InformationDid you Dirve* Yes No Transportation* Air/train/bus company. Mileage points don't count towards your Financial Reimbursement. Travel Receipt 1*Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB.Air Millage Points do not count towards your Financial Reimbursement Travel Receipt 2Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB.Air Millage Points do not count towards your Financial Reimbursement Travel Receipt 3Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB.Air Millage Points do not count towards your Financial Reimbursement Total Transportation*MileageMileage (x) miles,*Upload Mileage*Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB.Please upload Google Maps or Map Quest in PDF / Screen Shot/ Photo depicting mileage from point A to B.Mileage Reimbursement*Mileage x .56 of mile drivenMealsPlease include Meal Receipts.Do you have Meal Receipts?* Yes No Meal Receipts 1* Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. You may upload 6 receipt files/images in each receipt field.Meal Receipts 2 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. Meal Receipts 3 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. Total Meal Recipts*Other ExpendituresDo you have other Expenditures?* Yes No Taxi, Uber, Shuttle, Tolls and other miscellaneous expenses.Other Expences Receipts 1* Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. You may upload 6 Expense receipt files/images in each receipt field.Other Expences Receipts 2 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. You may upload 6 Expense receipt files/images in each receipt field.Other Expences Receipts 3 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 6. You may upload 6 Expense receipt files/images in each receipt field.Total Other Expences*TotalsTotal of Actual Expenses*Total Maximum Reimbursable Amount*Set by the ICES Board of Directors (Current BOD Reimbursable maximum amount for Attendance is $750.00)Total Requested Amount*By checking I Agree, I certify that the expenses shown are accurately reported and were actually for the business purpose indicated. All payments will be made is US Dollars.I Agree* Digital Signature Additional CommnetsThis form is not complete unless you click “submit" and will be used as your digital signature. Once you have submitted the form you should receive a “Thank You” confirmation email. If you do not receive this “Thank You” email then your form DID NOT go through and you will need to RE-SUBMIT your form. Please double check to make sure you: Have filled in all the required information, (a RED message will appear if information is missing).Este formulario no está completo a menos que haga clic en "enviar".Una vez que haya enviado el formulario, debe recibir un correo electrónico de confirmación de "Gracias". Si no recibe este correo electrónico de "Agradecimiento", entonces su formulario NO se envió y tendrá que REITERAR su formulario.Por favor, vuelva a verificar para asegurarse de que:Ha completado toda la información requerida (aparecerá un mensaje ROJO si falta información).CommentsThis field is for validation purposes and should be left unchanged. Δ
