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 FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If "Other"*Hotel InformationDid you stay at the Host Hotel*YesNoIf 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 Accepted file types: pdf, jpg, jpeg. 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 Accepted file types: pdf, jpg, jpeg. Hotel Receipt 3 Drop files here or Accepted file types: pdf, jpg, jpeg. Hotel Cost*Transportation InformationDid you Dirve*YesNoTransportation*Air/train/bus company. Mileage points don't count towards your Financial Reimbursement. Travel Receipt 1*Accepted file types: pdf, jpg, jpeg.Air Millage Points do not count towards your Financial Reimbursement Travel Receipt 2Accepted file types: pdf, jpg, jpeg.Air Millage Points do not count towards your Financial Reimbursement Travel Receipt 3Accepted file types: pdf, jpg, jpeg.Air Millage Points do not count towards your Financial Reimbursement Total Transportation*MileageMileage (x) miles,*Upload Mileage*Accepted file types: pdf, jpg, jpeg.Please upload Google Maps or Map Quest in PDF / Screen Shot/ Photo depicting mileage from point A to B.Mileage Reimbursement*Mileage x .575 of mile drivenMealsPlease include Meal Receipts.Do you have Meal Receipts?*YesNoMeal Receipts 1* Drop files here or Accepted file types: pdf, jpg, jpeg. You may upload 6 receipt files/images in each receipt field.Meal Receipts 2 Drop files here or Accepted file types: pdf, jpg, jpeg. Meal Receipts 3 Drop files here or Accepted file types: pdf, jpg, jpeg. Total Meal Recipts*Other ExpendituresDo you have other Expenditures?*YesNoTaxi, Uber, Shuttle, Tolls and other miscellaneous expenses.Other Expences Receipts 1* Drop files here or Accepted file types: pdf, jpg, jpeg. You may upload 6 Expense receipt files/images in each receipt field.Other Expences Receipts 2 Drop files here or Accepted file types: pdf, jpg, jpeg. You may upload 6 Expense receipt files/images in each receipt field.Other Expences Receipts 3 Drop files here or Accepted file types: pdf, jpg, jpeg. 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 DirectorsTotal 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).PhoneThis field is for validation purposes and should be left unchanged.
