Event Expense and Payroll Form Name*Email PhoneEvent Name/Clinic Topic*Date Resort*Do you have hours worked to report?YesNoA per diem of $70 for a full day and $35 for half day will be automatically added to each day worked.Start Time* : HH MM AM PM End Time : HH MM AM PM Did you work a 2nd day?YesNoStart Time : HH MM AM PM End Time : HH MM AM PM Did you work a 3rd Day?YesNoStart Time : HH MM AM PM End Time : HH MM AM PM Did you work a 4th day?YesNoStart Time : HH MM AM PM End Time : HH MM AM PM Miles DrivenOnly the owner of the vehicle driven is eligible to submit miles to be reimbursed. Miles should reflect the most direct route. Did you carpool?*YesNoLodging Expenses?*YesNoTotal Lodging ExpenseWe need a receipt for lodging to be reimbursed $60 per night double occupancy; $100 per night single occupancy. These amounts are all inclusive. If lodging is provided, reimbursement for lodging will not be approved. Receipt for LodgingPlease refer to the Employee Handbook for amounts to be reimbursed and reimbursement policies. If you have trouble attaching your receipt please email a copy to firstname.lastname@example.orgLift Ticket Expense?*YesNoTotal Ticket ExpenseReceipt for Lift TicketsIf you have trouble attaching your receipt please email a copy to email@example.comAny other expenses?*YesNoAll additional expenses need to be approved. Please see the Employee Handbook for guidelines for acceptable reimbursements. Remember that your $35/half day and $70/full day Per Diem serves to cover meals and incidental expenses (minor fees or costs incurred at the event paid for during business activities).Explanation and amount of additional expensesReceipts for Additional ExpensesIf you have trouble attaching your receipt please email a copy to firstname.lastname@example.orgSignatureAll hours and expenses are expected to follow the rules and guidelines set in the Employee Handbook. Everything stated above is correct.