Fill out this form in its entirety. Original receipts are required for all expenses except per diem. A Mapquest printout must be included when requesting mileage for car travel. You must include the payment confirmation and the hotel check-out receipt when requesting reimbursement for lodging. For air travel, you must include the payment confirmation. If you book your hotel on services such as Hotels.com, this internet receipt will not be honored. You must ask for a final receipt from the hotel when you check out. Rental cars and airline upgrades are not covered.
Original receipts, a signed/dated W-9, and this signed/dated form must be mailed to Grants Department at P.O. Box 709, Chattanooga, TN 37401-0709. Claims must be sent complete in ONE packet including all receipts. Incomplete packets and unsubstantiated claims will not be funded.
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