Biology Reimbursement Request Form

Personal Information

Full Legal Name*

First Last

Do you have a preferred name for communications?*

Yes
No

Preferred Name for Communications*

First Last

Email*

We will contact you with any questions.

Enter Email Confirm Email

Affiliation*

BU Student
Guest

Mailing Address*

For reimbursement check

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

Expense Information

BU Host, Advisor, or Supervisor Name*

First Last

BU Host, Advisor, or Supervisor Email*

Enter Email Confirm Email

10-Digit BU Account Number (to charge for expenses)*

Note: this is different from your BU ID number. If you have questions about this, please email Olivia Thorpe at oliviavt@bu.edu.

The above account number has been confirmed by your advisor or supervisor AND the expenses have been approved to charge to this account*

Yes

Expense Name*

Purpose of Expense*

Expense Date or Trip Start Date*

Expense Date or Trip End Date*

Reimbursement Expense Type*

Please check all that apply.

Airfare
Lodging
Bus/Train Tickets
Car Mileage
Meal
Taxi
Conference Registration
Honorarium
Other

If other, please describe:*

Please List all expenses and then upload any corresponding receipts below. For car mileage, include the miles driven under Expense and TBD under Cost (Ex: Car mileage, 50 miles | TBD).*

Provide a description and cost for each receipt uploaded (Ex: Airfare, roundtrip SFO > BOS | $350.00; Taxi from home to SFO | $15.00; Taxi from BOS to hotel | $10.00, etc.). Click the (+) to add another row.

Expense	Cost (e.g. $150.00)

Airfare Receipt and Itinerary Upload*

Please upload a receipt AND itinerary for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Name of Airline(s) Traveled*

Lodging Upload*

Please upload a receipt for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Bus/Train Receipt Upload*

Please upload a receipt for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Car Mileage – Beginning Trip Address*

Please include the beginning address for your trip to BU. This will be used to calculate mileage costs. Mileage is used to cover the cost of gas and car usage. Gas receipts will not be reimbursed.

Street Address Address Line 2 City State ZIP Code

Car Mileage – Ending Trip Address*

Please include the ending address for your trip to BU. This will be used to calculate mileage costs. Mileage is used to cover the cost of gas and car usage. Gas receipts will not be reimbursed.

Street Address Address Line 2 City State ZIP Code

Meal Itemized Receipt Upload*

Please upload an itemized receipt for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Taxi Receipt Upload*

Please upload a receipt for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Start and End Destination(s)*

Please include a start and end destination for each taxi trip (e.g. Trip 1: Airpot to hotel, Trip 2: Hotel to Airport, etc.). Click the (+) to add another row.

Conference Registration Receipt Upload*

Please upload a receipt for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Other Receipt Upload*

Please upload a receipt for each expense. All receipts should be clearly legible (double-check scans or pictures for image quality). PREFERRED FILE NAMING: "ExpenseType_DatePurchased" (ex: Airfare_01-20-20.pdf, BusToBoston_01-20-20.pdf, etc.)

Drop files here or

Max. file size: 100 MB.

Additional Information

Please include any comments or explanations below:

Optional

Thank you!

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