Student Expense Form
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2BSU Clubs & Organizations
Student Expense Form
This form is for student organization members who need to be reimbursed for an expense they have incurred on behalf of their organization.
Name:
Student Address:
Student Phone:
Student ID:
Student Email:
Organization Account #:
Organization Name:
:
Reimbursement for Expenses:
Reimbursement for Travel
(travel authorization must be approved before travel)
Dates of Travel:
Destination:
Date
Vendor
Description
Amount
Reason for Travel:
Registration Fee:
Students are not reimbursed
Lodging:
for meal costs in travel. If
SAFAC funded, lodging is
Mileage
:
(calc below)
limited to $25/person per
Other:
night.
Students may not be reimbursed for
Total for this trip:
tax. For more information, see page 2.
Subtotal of expenses:
Type of vehicle
Mileage rate
x Total Miles
= Total
Personal vehicle
.575/mile
Total amount to be paid to student
BSU vehicle
BSU vehicles will be charged directly to org account
Requester:
________________________________________Date: __________
printed name
signature
Documentation of expenses must be attached.
Advisor:
________________________________________Date: __________
Examples:
printed name
signature
Receipts
•
Paid invoices
•
________________________________________Date: __________
HMU Assoc. Dir:
Copy of registration form (for conference fees)
•
printed name
signature
________________________________________Date: __________
Business Office:
printed name
signature
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Parent category: Business