CDIP SCHOLAR & MENTOR EXPENSE REPORT FOR CDIP MINI GRANT AND TRAVEL GRANT PROGRAMS 2017/2018 ACADEMIC YEAR www.calstate.edu/hr/cdip
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. E-mail all parts of the Final Report to Rocio Hidalgo at rhidalgo@calstate.edu.
(MUST BE TYPED) 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 1
FINAL EXPENSE REPORT FOR SCHOLAR Scholars 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. TRAVEL INFORMATION Please provide details regarding your requested travel below. Trip Funded By: Mini-Grant Fall Travel Grant Spring Travel Grant Location: Travel Dates: Departure City: Arrival City: If requesting full reimbursement, please sign. I have not received reimbursement for this travel claim from any other source. (Scholar s Signature) (Date) TRAVEL BUDGET FOR SCHOLAR Include description of each item in rows below. List estimated expense in the Total column. Total CO Use Only Ground Transportation only: estimated distance in miles Air Travel Departing City and State: Arriving City and State: Airfare: (53.5 cents per mile) (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: 2
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) Software (limit 1,000) Supplies (limit 1,000) Services (limit 1,000) Miscellaneous (limit 500) 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. Total Cost CO Use Only Total Cost: SCHOLAR REIMBURSEMENT INFORMATION: Check will be mailed to this address. Name Address City, State, Zip Email Address 3
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. TRAVEL INFORMATION Please provide details regarding your requested travel below. Trip Funded By: Mini-Grant Fall Travel Grant Spring Travel Grant Location: Travel Dates: Departure City: Arrival City: If requesting full reimbursement, please sign. I have not received reimbursement for this travel claim from any other source. (Mentor s Signature) (Date) TRAVEL BUDGET FOR MENTOR Include description of each item in rows below. List estimated expense in the Total column. Total CO Use Only Ground Transportation only: estimated distance in miles Air Travel Departing City and State: Arriving City and State: Airfare: (53.5 cents per mile) (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: continued on page 5 4
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. MENTOR REIMBURSEMENT INFORMATION: Check will be mailed to this address. Name Address City, State, Zip Email Address 5