TRAVEL & EXPENSE REIMBURSEMENT FORM

NAME: DATES COVERED:

A)	ADVANCE APPROVAL (Required for all staff members. Applicable to Board Members in the case of foreign travel, special trips, conferences.): Description:

Approved by:	Date:

B)	ACTUAL EXPENSES

1.	Actual expense summary:	2.	Business Purpose & Benefit

For regular meetings and conferences, please

Conference Fees	attach conference agenda and describe benefit

to the Foundation. For special and foreign

Airfare/Train/Bus	trips or conferences, a written report is

required regarding the purpose thereof and an

Car Mileage	evaluation of the activity, event, conference,

( mi x 44.5¢/mi)	meeting or interview attended that required

the travel.

Parking	Check all applicable boxes:

□	Research/discussion on policy issues and

Tolls	prospective grant opportunities

□	Review and discuss grantee organization and

Taxi	operations

□	Evaluate grantee performance

Hotel/Lodging	□	Review proposed grant award(s)

□	Presentation of speech, paper or panel

Personal Meals	participation

□	Review and discuss Foundation grant budget

Business Meals*	□	Discuss general Foundation administrative

matters

Miscellaneous	□	Employee career planning and/or evaluation

□	Other (Describe):

TOTAL	$

(Use reverse if necessary.)

3.	*Guests (Name, title, affiliation):

4.	Submitted By:	Date:

5.	Reimbursable Expenses Approved By: Date:	President, Michael W. Grebe

C)	ACCOUNTING USE ONLY

Amount $____________________	Approved for Payment:

Date Paid:	Comp. Chkd. By:

Check No.	Charge Account:

(F-T&E2: 1/01/06)

2.	Business Purpose & Benefit, continued: