CDIP SCHOLAR &MENTOREXPENSEREPORT

FOR CDIP MINI GRANT AND TRAVEL GRANT PROGRAMS2017/2018 ACADEMIC YEAR

www.calstate.edu/HR/CDIP

2017/2018 CDIP SCHOLAR DEVELOPMENT EXPENSE REPORT

FINAL REPORTS FOR CDIP SCHOLAR AND MENTOR A Final Activity Report and Final Expense Report are due within two weeks of completion of all approved activities. Scholars are to submit the Final Activity Report and Final Expense Report. Mentors are to submit only the Final Expense Report.

The narrative of the Final Activity Report should be one page in length. It should include:

• A brief description of activities undertaken.

• A summary of what was accomplished and earned, both expected and unexpected.

• If Mentor traveled with Scholar, a description of mentor’s role and contribution for and during the trip.

The Final Expense Report must include:

• Exact purchase and travel dates.

• Itemized receipts in chronological order.

• When using companies (such as Expedia) that bundle travel, an itemized final hotel receipt that lists daily charges and amounts paid. A bank or credit card statement listing the expense is not acceptable.

• Name badge or program page or link that shows traveler’s name and affiliation.

• Boarding passes that show traveler’s name for air travel.

• Conference/workshop registration receipt with traveler’s name and affiliation.

• Evidence of professional presentation, if applicable. This includes conference/workshop program, schedule or proceeding showing the scholar’s name and title of presentation.

Please submit your reimbursement by email to Rose at rhidalgo@calstate.edu. Make sure to indicate in the email subject: {Your Name} Final Expense Report – TG Fall 2018. Proper naming of your email will prevent delays in the processing of your reimbursement. Keep all original receipts until you have received your reimbursement.

12017/2018 CDIP SCHOLAR DEVELOPMENT EXPENSE REPORT

FINAL ACTIVITY REPORT FOR PRINT NAME

Due within two weeks of completion of all proposed activities. In addition to this Final Activity Report, complete the Final Expense Report entering all approved expenses. Be sure to include all receipts (in chronological order) to receive reimbursement. If you make a presentation at a conference you must also include a copy of a page from the conference program with your name and the presentation title. Please email all parts of the Final Reports together. Original receipts may be requested.

BRIEF DESCRIPTION OF ACTIVITIES UNDERTAKEN

SUMMARY OF WHAT WAS ACCOMPLISHED AND LEARNED/OUTCOMES, BOTH EXPECTED AND UNEXPECTED

REFLECTION ON THE EXPERIENCE OF SHARING OUTCOMES IN A PROFESSIONAL VENUE

(MUST BE TYPED)

22017/2018 CDIP SCHOLAR DEVELOPMENT EXPENSE REPORT

FINAL EXPENSE REPORT FOR SCHOLARScholars must complete this Final Expense Report and the Final Activity Report. Be sure to include all required documentation and receipts in chronological order to receive reimbursement. Please email all parts of the Final Reports together. Original receipts may be requested.

If requesting full reimbursement, please sign. I have not received reimbursement for this travel claim from any other source.

(Scholar’s Signature)

(Date)

Trip Funded By: Mini-Grant Fall Travel Grant Spring Travel Grant

Location:

Travel Dates:

Departure City:

Arrival City:

TRAVEL INFORMATIONPlease provide details regarding your requested travel below.

Ground Transportation only: estimated distance in miles (53.5 cents per mile)

Air Travel

Departing City and State:

Arriving City and State:

Airfare: $

(Provide travel itinerary or documentation with estimated round trip airfare between departure city and arrival city)

Lodging

Number of nights:

Cost per night: $

(Maximum $195/night - provide documentation of the daily rate)

Early Registration: $

Membership: $

Total Expenses:

TRAVEL BUDGET FOR SCHOLARInclude description of each item in rows below. List estimated expense in the “Total” column.

CO Use OnlyTotal

$

$

$

$

$

32017/2018 CDIP SCHOLAR DEVELOPMENT EXPENSE REPORT

SCHOLAR REIMBURSEMENT INFORMATION:Check will be mailed to this address. Name

Address

City, State, Zip

Email Address

Total Cost CO Use Only

MINOR EQUIPMENT, SOFTWARE AND SUPPLIES (FOR MINI-GRANT ONLY)For each item, provide specific description of item, cost (include price, tax and S&H if applicable), and justification/rationale. Please attach additional sheets if necessary.

Category

Minor Equipment (limit $1,000)

Description:

Justification:

Software (limit $1,000)

Description:

Justification:

Supplies (limit $1,000) Description:

Justification:

Services (limit $1,000)

Description:

Justification:

Miscellaneous (limit $500)

Description:

Justification:

Total Cost:

Examples include translations, transcriptions, coding, and analysis. Quote from a vendor must be submitted.

Examples include books, journal subscriptions, and professional organization memberships. Must provide an itemized budget with title and cost of each book, subscription, or membership.

$

$

$

$

$

$

42017/2018 CDIP SCHOLAR DEVELOPMENT EXPENSE REPORT

FINAL EXPENSE REPORT FOR MENTOR TO BE PREPARED BY MENTOR ONLY

Be sure to include all receipts in chronological order to receive reimbursement. Please email all parts of the Final Report together. Original receipts may be requested.

If requesting full reimbursement, please sign. I have not received reimbursement for this travel claim from any other source.

(Mentor’s Signature)

(Date)

Trip Funded By: Mini-Grant Fall Travel Grant Spring Travel Grant

Location:

Travel Dates:

Departure City:

Arrival City:

TRAVEL INFORMATIONPlease provide details regarding your requested travel below.

Ground Transportation only: estimated distance in miles (53.5 cents per mile)

Air Travel

Departing City and State:

Arriving City and State:

Airfare: $

(Provide travel itinerary or documentation with estimated round trip airfare between departure city and arrival city)

Lodging

Number of nights:

Cost per night: $

(Maximum $195/night - provide documentation of the daily rate)

Early Registration: $

Membership: $

Total Expenses:

TRAVEL BUDGET FOR MENTORInclude description of each item in rows below. List estimated expense in the “Total” column.

CO Use OnlyTotal

$

$

$

$

$

continued on page 5

52017/2018 CDIP SCHOLAR DEVELOPMENT EXPENSE REPORT

MENTOR REIMBURSEMENT INFORMATION:Check will be mailed to this address. Name

Address

City, State, Zip

Email Address

FINAL EXPENSE REPORT FOR MENTOR TO BE PREPARED BY MENTOR ONLY

Be sure to include all receipts in chronological order to receive reimbursement. Please email all parts of the Final Report together. Original receipts may be requested.