<p> Private & Parochial Schools in Madison Metropolitan School District REIMBURSEMENT FORM – OUT OF DISTRICT PROFESSIONAL ACTIVITY 2014-15</p><p>We have recently implemented a new policy. You will need to verify that your reimbursement has been completed properly in order to receive your reimbursement in a timely manner. Reimbursements requiring a large number of corrections or with more than one individual listed per form will be returned. Therefore, please use the following checklist before submitting your reimbursement. Reimbursement Checklist  One form submitted per person requesting reimbursement</p><p>Registration:  Must include a copy of the registration receipt for reimbursement.  Should also include a conference agenda whenever possible with the courses attended highlighted.  Only non-religious based workshops/courses will be reimbursed. If Professional Development Activity includes religious-based sessions, please highlight all of the sessions you attend and we will provide a percentage of reimbursement based on non-religious sessions attended.</p><p>Meals  Must include all itemized receipts. If dining with others, whenever possible get a separate receipt or your meal items should be clearly marked.  Tips and taxes should be included in the total for the meal and written on the receipt. Tips should be limited to 15%.  Meals must not exceed $35/day in-state; $40/day out of state  The reimbursement must not contain any alcohol. We will not reimburse tax/tip on alcohol.  Meals outside the conference dates or after the scheduled hours of a local workshop will not be approved unless they are reasonable due to travel. For example: If conference ends at 3:00 p.m. in Chicago. A 7:30 p.m. dinner in Madison would not be eligible for reimbursement.</p><p>Travel  Gasoline reimbursement for a rental car is acceptable. It is not acceptable for a personal vehicle as you are reimbursed an amount per mile which covers the cost of gas.  A compact rental car should be chosen if employee is traveling alone. Mid or full-size is acceptable if traveling with a group.  Must include receipt for air travel and baggage fees for reimbursement.</p><p>Hotel  The reimbursement can include lodging tax when traveling.</p><p>Receipts  Telephone charges will be reviewed by MMSD and should be reasonable.  Original receipts must be attached to the reimbursement.  Receipts are taped to white sheets of paper, grouped by date, with the date written above each receipt. </p><p>Please mail your completed forms with all attachments to: Attn: Stephanie Dankert , State and Federal Programs Room 124, Madison Metropolitan School District, 545 West Dayton Street, Madison, WI 53703</p><p>Private & Parochial Schools in Madison Metropolitan School District 5.21.2014 REIMBURSEMENT FORM – OUT OF DISTRICT PROFESSIONAL ACTIVITY 2014-15 Mileage Effective 1/2014 Mileage may change each year in January. Please check with MMSD prior to submitting reimbursement request for 2015. DIRECTIONS FOR EXPENSE REIMBURSEMENT: 1. After participating in the Out of District Professional Activity fill out this form for reimbursement 2. Attach original and itemized receipts for reimbursement. No Item will be reimbursed without receipts, except mileage. a. Receipts must be itemized b. No Alcohol will be reimbursed c. Room tax will be reimbursed d. Telephone charges will be reviewed by MMSD 3. Send this form, your receipts, and a copy of the request form to your Private School Principal/Administrator for approval. 4. Send to Stephanie Dankert at Madison Metropolitan School District. 1. Printed Name: /School: 3. Name & location of 2. Conference Date(s): Conference:</p><p>(For MMSD Use Only) Mo Total Account 4. Expenses Incurred Sat Sun n Tue Wed Thu Fri Expense Numbers DATES</p><p>Employee paid Registration Employee paid airline Expense Car Rental Room Cost/Night with Taxes Mileage-Number of Miles ($0.56/mile for Meals1/2014) ($35/day in-state; $40/day out-of-state) Taxi/Tolls/Parking/Gas (gas reim only for rentals) Telephone</p><p>Other TOTALS Amount Due to Employee:</p><p>Employee Signature: Date: Private/Parochial Principal/Administrator Date: Signature:</p><p>MMSD Title II Director Approval: Date:</p><p>5.21.2014 5.21.2014</p>