Travel Reimbursement Speakers

Travel Reimbursement-Symposia Speakers

"*" indicates required fields

Name*

First Last

Address*

We recommend that you provide a home address for your check since that will generally lead to quicker more secure delivery. If at all possible, we recommend not using address Line 2.

Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address*

Email Address of the Organizer*

You need to include the email address of the symposia organizer or regional meeting organizer--the person who is communicating with you directly on how to get reimbursed.

ACS Meeting Symposia Name or Regional Meeting*

Include the name of the symposia where you gave your talk at the ACS Meeting or the case of a regional meeting provide the name of that meeting and if applicable symposia name.

Talk Date*

Include the date of your presentation/talk.

Amount requested for reimbursement*

Receipts are required for all expenses. Hotel, meeting registration and transportation costs are eligible for reimbursement. Meal expenses are not eligible for reimbursement.

Upload PDF File with Receipts*

In a single PDF file that you upload below, please be sure to include: the reimbursement form and all relevant receipts. Name the file using the format: lastname_firstname_$xx.xx.pdf where $xx.xx is the amount to be reimbursed i.e. Smith_Jane-$576.83.pdf.

Accepted file types: pdf, Max. file size: 98 MB.

Reimbursement Confirmation*

I certify that I am authorized to receive these funds for travel and that I am not seeking the same reimbursement elsewhere. I also certify that I am submitting this claim on time (likely within 14 days after end of the meeting-program officers are required to have this to the treasurer within 30 days of a meeting and the Treasurer must complete all reimbursements with 45 days), otherwise I may not be eligible for reimbursement and/or I may have to claim this reimbursement to IRS as income.

I Agree