SAPCC Annual Reps Meeting Travel Reimbursement Please Read Representatives, Ambassadors and Acting Representatives must attend all three (3) Annual Representatives Meeting sessions to be eligible to receive the maximum attendance reimbursement amount of $300. Representatives, Ambassadors and approved Acting Representatives are eligible for (One Hundred Dollars) $100.00 per session attended, only if all prerequisites are met and verified. All Representatives, Ambassadors and Acting Representatives must upload copies of all receipts plus a written report on the activities of the Annual Representatives Meeting with this form. All contracts, forms and reports for the S/A/P/C/C must have been received before their deadline for any reimbursement to be disbursed. Representatives and Acting Representatives will be eligible only for the amount actually incurred, to attend the Annual Representatives Meeting, up to the maximum reimbursement amount of (three hundred dollars) $300.00. All requests for reimbursements must be submitted online within thirty (30) days of the close of the Annual Representatives Meeting. All reimbursements will be issued in U.S. funds. Your InformationS/A/P/C/C Name* Please select your State, Area, Providence, Country or Chapter name.Name* First Last Phone*Primary contact numberAlt PhonePlease enter alternate phone number if applicable.Email* 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 S/A/P/C/C Position*Representative/AmbassadorActing RepresentativeRep Moderator/SecretaryReminder: All requests must be accompanied by receipts for the expenses claimed and an Annual Representatives Meeting Report. All S/A/P/C/C Reports must be current (filed by the due date) for any monies to be reimbursed.Did you stay at the Host Hotel* Yes No You must stay at the Host Hotel for Reimbursement for the Annual Representatives Meeting.HotelHotel Reimbursement is 3 days of ICES Block only for the Annual Representatives Meeting.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: 3. Hotel Points do not count towards your Financial Reimbursement Hotel Receipt 2 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 3. Hotel Receipt 3 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 3. Hotel Cost*Please include the night before and the days you attended for the Annual Representatives Meeting while staying in the ICES Block.TransportationDid you drive* No Yes Transportation* Air/train/bus company. Mileage points don't count towards your Financial Reimbursement. Travel Receipt 1* Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 3. Air Millage Points do not count towards your Financial Reimbursement Travel Receipt 2 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 3. Travel Receipt 3 Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 256 MB, Max. files: 3. Total Transportation*Add up your transportation receipts.MileageMileage (x) miles,* This is for Driving Miles only.Upload Mileage*Accepted file types: pdf, jpg, jpeg, png, 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 cents per mile.MealsPlease include Meal Receipts for only the 3 days of the Annual Representatives Meeting.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 Expenses*Add Meal Receipts and enter it here.Other ExpendituresUpload receipts for Taxi, Uber, Shuttle, Tolls and other miscellaneous expenses.Do you have other Expenditures?* Yes No Taxi, Uber, Shuttle, Tolls and other miscellaneous expenses.Other Expence 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 Expence 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 Expence 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 ExpensesAdd all Other Expenses and place hereTotalsTotal Expenses*Total Annual Representatives Meeting ExpensesTotal Maximum Reimbursable Amount*Please enter a number from 0 to 300.Reimbursable Amount*Please enter a number from 0 to 300.Total Maximum Reimbursable Amount (Not to exceed $300 (Three Hundred Dollars) U.S. funds.Annual Representatives Meeting ReportYou must upload your notes taken during the Annual Representatives Meeting including motions, guest speakers, topics and discussions during the meeting to be considered for reimbursement.Meeting Notes*Max. file size: 256 MB.Please upload your Meeting Report/Notes from the Annual Representatives Meeting.Terms AgreementBy clicking “I agree”,: You agree to use an electronic signature to demonstrate my acceptance of the below information. I understand and agree that an electronic signature and/or electronic acceptance is as legally binding as an ink signature. Representatives, Ambassadors and Acting Representatives must attend all three (3) Annual Representatives Meeting sessions to be eligible to receive the maximum attendance reimbursement amount of $300. Representatives, Ambassadors and approved Acting Representatives are eligible for $100.00 per session attended, only if all prerequisites are met and verified. All Representatives, Ambassadors and Acting Representatives must upload copies of all receipts plus a written report on the activities of the Annual Representatives Meeting with this form. All contracts, forms and reports for the S/A/P/C/C must have been received before their deadline for any reimbursement to be disbursed. Representatives and Acting Representatives will be eligible only for the amount actually incurred, to attend the Annual Representatives Meeting, up to the maximum reimbursement amount of $300.00 (three hundred dollars). All requests for reimbursements must be submitted online within thirty (30) days of the close of the Annual Representatives Meeting. All reimbursements will be issued in U.S. funds. I Agree* Digital Signature I agree to the terms.This 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).NameThis field is for validation purposes and should be left unchanged. Δ
